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The cervical esophagus is exposed via a ventral midline approach. The paired sternohyoid muscles are bluntly separated along the midline, as are the deeper sternothyroid and more superficial sternocephalicus muscle pairs as the incision extends caudally. This exposes the trachea, which is retracted to the right, together with the recurrent laryngeal nerves that lie alongside it. This approach can be complemented with a cranial partial sternotomy, should a more caudal exposure prove necessary. The vagosympathetic trunks and common carotid arteries also run close to the esophagus. Soft plastic tubing may be advanced through the mouth and along the esophagus to aid the surgeon in identifying the esophagus via palpation. Other considerations are as for thoracic esophagotomy.