Surgical approach for common carotid ligation at the level of the medial retropharyngeal lymph node in dogs: A comparative cadaveric study

OBJECTIVE: To describe procedural details of a unilateral or bilateral temporary or permanent ligation of the common carotid artery (CCA) at the level of the medial retropharyngeal lymph node (MRLN), with or without concurrent lymphadenectomy in dogs. STUDY DESIGN: Computed tomographic (CT) and cadaveric study. ANIMALS: Medium breed (15-35 kg) client-owned dogs undergoing CT evaluation (n = 10) and cadaver dogs (n = 12). METHODS: A total of 10 dog contrast-enhanced CT scans were evaluated for spatial assessment of the carotid artery, regional lymphocenters, and adjacent anatomy. A total of 12 dog cadavers were randomized to undergo two of four surgical procedures for carotid artery ligation at the level of the MRLN: lateral or ventral approach, with or without lymphadenectomy. Feasibility, consistency of anatomical landmarks, and completeness of carotid isolation were assessed. RESULTS: CT evaluation consistently identified the CCA dorsomedial to the MRLN and the MRLN medial to the caudodorsal mandibular salivary gland. Both approaches provided reliable access to the CCA and cervical lymph nodes. CCA ligation was successfully performed bilaterally in all cadavers, with and without lymphadenectomy. No gross evidence of vascular trauma was observed. CONCLUSION: The described approach may be used to minimize intraoperative bleeding in dogs undergoing maxillofacial surgery and may take advantage of planned unilateral or bilateral lymphadenectomy, minimal additional dissection, and elective permanent ligation. CLINICAL SIGNIFICANCE: CCA ligation at the level of the MRLN may provide an adaptable surgical approach to the CCA and cervical lymph nodes in dogs. Further evaluation of this approach in clinical dogs undergoing maxillofacial procedures is warranted to determine potential intraoperative procedural complications.