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Remove the visceral fascia that invests the pharynx, esophagus, trachea, and associated structures. Also remove any remaining remnants of the carotid sheath that surrounds the common and internal carotid arteries, internal jugular vein, and the vagus nerve.Identify the cervical portion of the sympathetic trunk. Its superior end is at the level of the second cervical vertebra and lies posterior to the carotid sheath between the prevertebral and visceral fascia layers. The apical portion of the sympathetic trunk is usually reflected along with the soft tissues of the neck as the skull is displaced anteriorly.
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