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We present anatomical features of the styloid diaphragm, which limits access to the highest portion of the cervical internal carotid artery. Based on the features, we also present a non-invasive technique of approach to the high cervical internal carotid artery lesion. The inferior margin of the styloid diaphragm is a useful preoperative landmark in carotid endarterectomy for determining whether the lesion is surgically accessible.

Surgical Anatomy of Styloid Diaphragm for Carotid Endarterectomy in Patients with High Cervical Carotid Artery Stenosis