Anatomical variations in the course of spinal accessory nerve in the neck triangles: A descriptive study.
Anatomy
Internal jugular vein
Sternocleidomastoid
Trapezius
Journal
Morphologie : bulletin de l'Association des anatomistes
ISSN: 1286-0115
Titre abrégé: Morphologie
Pays: France
ID NLM: 9814314
Informations de publication
Date de publication:
13 Feb 2024
13 Feb 2024
Historique:
received:
22
10
2023
revised:
23
12
2023
accepted:
24
12
2023
medline:
15
2
2024
pubmed:
15
2
2024
entrez:
14
2
2024
Statut:
aheadofprint
Résumé
Spinal Accessory Nerve (SAN), which innervates the sternocleidomastoid (SCM) and trapezius muscles, is closely related to the internal jugular vein (IJV) in the anterior triangle of the neck and passes superficially in the posterior triangle. Injury to SAN is a major complication of level II neck dissection, leading to shoulder syndrome. The present study aims to assess the course and its relation to the SCM muscle and IJV in the Tamil ethnolinguistic groups in South India. The anterior and posterior triangles of the neck were dissected in 28 formalin-fixed adult cadavers. The course of the SAN and the entry and exit points of SAN along the SCM muscle were assessed using the mastoid process as the reference. Recorded data was analyzed using SPSS software. The SAN was anteriorly related to the IJV in 58.73%, posteriorly in 37.5%, and pierced through the IJV in 3.57% of the specimens. The entry and exit points of SAN from the mastoid process were 37.86±7.26mm and 48.55±8.22mm, respectively. In 86.67% of the cases, the SAN traversed through the SCM muscle, and in 13.33%, it was deep to the SCM. The present study reports that the SAN is variable in its course, and relation to SCM and IJV. Knowledge about the variant anatomy of the SAN in the triangles of the neck is important and it aids surgeons to prevent iatrogenic injuries to SAN or IJV and enhance surgical safety in neck procedures.
Sections du résumé
BACKGROUND
BACKGROUND
Spinal Accessory Nerve (SAN), which innervates the sternocleidomastoid (SCM) and trapezius muscles, is closely related to the internal jugular vein (IJV) in the anterior triangle of the neck and passes superficially in the posterior triangle. Injury to SAN is a major complication of level II neck dissection, leading to shoulder syndrome. The present study aims to assess the course and its relation to the SCM muscle and IJV in the Tamil ethnolinguistic groups in South India.
METHODS AND MATERIALS
METHODS
The anterior and posterior triangles of the neck were dissected in 28 formalin-fixed adult cadavers. The course of the SAN and the entry and exit points of SAN along the SCM muscle were assessed using the mastoid process as the reference. Recorded data was analyzed using SPSS software.
RESULTS
RESULTS
The SAN was anteriorly related to the IJV in 58.73%, posteriorly in 37.5%, and pierced through the IJV in 3.57% of the specimens. The entry and exit points of SAN from the mastoid process were 37.86±7.26mm and 48.55±8.22mm, respectively. In 86.67% of the cases, the SAN traversed through the SCM muscle, and in 13.33%, it was deep to the SCM.
CONCLUSION
CONCLUSIONS
The present study reports that the SAN is variable in its course, and relation to SCM and IJV. Knowledge about the variant anatomy of the SAN in the triangles of the neck is important and it aids surgeons to prevent iatrogenic injuries to SAN or IJV and enhance surgical safety in neck procedures.
Identifiants
pubmed: 38354627
pii: S1286-0115(23)00248-5
doi: 10.1016/j.morpho.2023.100761
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
100761Informations de copyright
Copyright © 2023 Elsevier Masson SAS. All rights reserved.