The anteromedial approach is an extension of the Smith-Robinson approach. It is medial to the sternocleidomastoid muscle and medial to the carotid sheath. This method allows exposure from Cl to T21 and can be combined with an osteotomy of the sternoclavicular jOint to allow a greater exposure at T2. The thoracic duct must be avoided with the left anteromedial approach. The recurrent laryngeal nerve should be identified with the right -side approach. The inferior thyroid artery and vein may need ligation, and the apex of the lung must be avoided.
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