For a cranial autopsy, where should the incision begin?

• A. Anterior to the tragus
• B. Superior and anterior to the top of the ear
• C. Posterior to the ear
• D. Inferior to the front of the ear lobe

Answer: (C)

Starting behind the ear is chosen because it sets the incision in a hidden, safe region (the mastoid area) that allows the scalp to be reflected upward and toward the vertex for a clean calvarial removal. This position avoids the external ear canal and other ear structures and provides the straight, continuous margin needed to expose the skull without damaging surrounding tissues. Incisions anterior to the tragus or near the front of the ear lobe risk damaging ear anatomy and do not offer the same optimal path for reflecting the scalp.