1. Anterior cervical–transsternal approach for resection of benign tumors at the thoracic inlet 
George Ladas, MD, Peter H Rhys-Evans, Peter Goldstraw 
The Annals of Thoracic Surgery 
Volume 67, Issue 3, Pages (March 1999)
DOI: /S (98)01323-X

2. Fig 1
The skin incision is placed along the anterior border of the sternocleidomastoid extending from the level of the thyroid cartilage downward onto the upper sternum.
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

3. Fig 2
The manubrium has been divided, as well as the strap muscles. The sternocleidomastoid is retracted laterally and the thyroid gland medially. (1 = sternum; 2 = thyroid; 3 = recurrent laryngeal nerve; 4 = common carotid artery; 5 = tumor.)
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

4. Fig 3
The common carotid artery (1) and vagus nerve (2) are retracted medially, exposing the scalenus anterior muscle with the phrenic nerve (3) and brachial plexus. The forceps points at the transverse cervical vessels. The brachial plexus is accessible once the scalenus anterior muscle is divided.
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

5. Fig 4
The complete dissection after removal of the tumor mass. (1 = common carotid artery; 2 = innominate vein; 3 = subclavian artery; 4 = vertebral artery; 5 = internal jugular vein; 6 = vagus nerve; 7 = recurrent laryngeal nerve.)
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

6. Fig 5
(A) Chest radiograph of a 67-year-old woman presenting with a 6-year history of right arm and hand pain of ulnar distribution and an ipsilateral painless mass at the root of the neck. A round opacity with smooth margins occupies the right apex. (B) Computed tomographic scan shows the soft tissue mass extruding through the thoracic apex, displacing the subclavian vessels anterolaterally. It proved to be a benign schwannoma arising from the T1 component of the brachial plexus. (C) Magnetic resonance imaging scan of the same patient showing a soft tissue mass wedged at the apex. Although there is a fat plane around the mass laterally and medially, its superior aspect is closely associated with the neurovascular bundle.
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

7. Fig 5
(A) Chest radiograph of a 67-year-old woman presenting with a 6-year history of right arm and hand pain of ulnar distribution and an ipsilateral painless mass at the root of the neck. A round opacity with smooth margins occupies the right apex. (B) Computed tomographic scan shows the soft tissue mass extruding through the thoracic apex, displacing the subclavian vessels anterolaterally. It proved to be a benign schwannoma arising from the T1 component of the brachial plexus. (C) Magnetic resonance imaging scan of the same patient showing a soft tissue mass wedged at the apex. Although there is a fat plane around the mass laterally and medially, its superior aspect is closely associated with the neurovascular bundle.
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)

8. Fig 6
(A) Preoperative chest radiograph from patient 2, with a smooth, rounded opacity at the right apex. (B) Preoperative computed tomographic scan showing the tumor, which was a benign schwannoma arising from the sympathetic chain.
The Annals of Thoracic Surgery  , DOI: ( /S (98)01323-X)