Anterior retropharyngeal approach to upper cervical spine described by McAfee et al. A, Submandibular incision. Lower limb of incision is used only if midcervical vertebrae must be exposed. B and C, Submandibular gland is resected, and digastric tendon is divided. Superior thyroid artery and vein also are divided. D, Hypoglossal nerve and superior laryngeal nerve are mobilized. Contents of carotid sheath are mobilized laterally, and hypopharynx is mobilized medially. E, Longus colli muscle is dissected laterally to expose anterior aspect of atlas and axis. SEETECHNIQUE 43.13.