How much neck extension would you require?

Pain and surgical outcomes with and without neck extension in standard open thyroidectomy: A prospective randomized trial

“…However, having said that, it would have been difficult to achieve the same degree of neck extension because each patient had different body habitus and shape, neck length, and tolerance to neck extension. Perhaps using an adjustable or inflatable bag might have improved the situation . However, the most direct and proper way of measuring neck extension during thyroidectomy would be to obtain an intraoperative fluoroscopic image …”