The submandibular (submaxillary) gland may be resected (see submaxillary gland resection) in continuity with the specimen in order to include peri-glandular nodal tissue.
The fascia and nodes of level II are dissected from the mastiod downward, exposing the internal jugular vein at the skull base, and the spinal accessory nerve entering the upper part of the sternocleidomastoid.
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The sternocleidomastoid is retracted posteriorly, and the nodal tissue of the posterior triangle (level V) is dissected from posterior to anterior, dividing the omohyoid and cervical plexus cutaneous branches.
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