🔍 Key Findings

• Both lateral and ventral approaches reliably permitted CCA isolation and ligation at the level of the MRLN, with or without concurrent lymphadenectomy; bilateral temporary ligation was successful in all 12 cadavers.
• The CCA was consistently dorsomedial to the MRLN, while the MRLN was medial to the caudodorsal mandibular salivary gland (MSG), providing reproducible landmarks for surgical orientation.
• Concurrent lymphadenectomy can be incorporated into the same surgical approach, permitting removal of the mandibular and medial retropharyngeal lymph nodes while gaining access to the CCA.
• Brachycephalic dogs had a significantly deeper CCA from the lateral approach than the ventral approach (44.8 ± 12.8 vs 29.3 ± 8.3 mm; p = .02), which may influence approach selection.
• No gross vascular trauma occurred after temporary CCA ligation, although careful dissection was required to avoid the adjacent vagosympathetic trunk.
• One inadvertent mandibular salivary gland capsular disruption occurred during a lateral approach without lymphadenectomy; Figure 2 demonstrates this complication and the close relationship of the MRLN, CCA, and vagosympathetic trunk.
• CCA ligation was performed at the cranial two-thirds of the MRLN, caudal to the internal carotid branching, placing the operative site near the carotid sinus and raising potential concerns for bradycardia and hypotension in live patients.
• Clinical efficacy remains unproven because this was a CT/cadaveric study; the authors specifically recommend in vivo evaluation of hemorrhage control, hemodynamic effects, and procedural complications.