Positional Relations of the Cervical Vagus Nerve Revisited

Planitzer, Uwe; Hammer, Niels; Bechmann, Ingo; Glatzner, J; Löffler, Sabine; Möbius, Robert; Tillmann, Bernhard; Weise, David; Winkler, Dirk

doi:10.1111/ner.12557

Cited by 17 publications

(18 citation statements)

References 48 publications

(92 reference statements)

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“…In most cases, it was located anteromedial in relation to the CCA. 11,14 The resulting VN CSA readings showed good intra-and interrater agreement. Agreement was consistently stronger for the distal ML-that is, at the level of the thyroid gland, where a clearly discriminable (hyper)echoic rim around the nerve facilitated identification and analysis.…”

Section: Discussionmentioning

confidence: 75%

“…We reliably identified the VN along its cervical course between the carotid sinus and the thyroid gland. In most cases, it was located anteromedial in relation to the CCA . The resulting VN CSA readings showed good intra‐ and interrater agreement.…”

Section: Discussionmentioning

confidence: 84%

“…In most cases, the VN was located laterally to the common carotid artery and dorsally to the internal jugular vein within the carotid sheath (Fig. ) . If necessary, color‐coded duplex sonography was added to prevent misinterpreting a small vessel within this hypervascularized region for being the VN.…”

Section: Methodsmentioning

confidence: 99%

“…1). 11 If necessary, color-coded duplex sonography was added to prevent misinterpreting a small vessel within this hypervascularized region for being the VN. After this overview scan, the VN was visualized bilaterally at 2 levels: the distal ML (in reference to the brainstem vagal nuclei complex) was at the level of the upper part of the thyroid gland, whereas the proximal ML was at the level of the proximal carotid sinus where the distal common carotid artery just starts to bulge.…”

Section: Methodsmentioning

confidence: 99%

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Sonographic evaluation of the vagus nerves: Protocol, reference values, and side‐to‐side differences

et al. 2017

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Sonographic evaluation of the vagus nerves: Protocol, reference values, and side‐to‐side differences

et al. 2017

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“…Therefore, in a surgical procedure, it is very important to know the relation of the vagus nerve with its surroundings and its positional anatomy inside the carotid sheath. Numerous studies have been done reporting the variational anatomy of the cervical vagus nerve (6)(7)(8)(9) .…”

Section: Discussionmentioning

confidence: 99%

Vagus Nerve Injury During Carotid Endarterectomy: A Cadaveric Study

Çırak¹,

Bozkurt²,

Yağmurlu³

2020

BMJ

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Objective: Vagus nerve injury is one of the most feared and highly prevalent complications of carotid endarterectomy (CEA). The aim of this study is to demonstrate the bilateral positional variations of the common carotid artery (CCA), vagus nerve and internal jugular vein (IJV) inside the carotid sheath in postmortem cadaveric specimens. Method: Carotid endarterectomy procedure was performed bilaterally step by step in 20 cadavers and every step was photographed. Positional variations of vagus nerve, CCA and IJV inside right and left carotid sheaths were evaluated. Results: In all dissections anatomical relations between vagus nerve and vascular structures were identified. The right vagus nerve was positioned posteriorly, medially, and anteriorly to IJV and CCA in 8 (40%), 4 (20%) and 4 (20%) of the specimens, respectively. In 2 (10%) specimens right vagus nerve was posterior to the IJV and in 2 (10) specimens' right vagus nerve was positioned posterior to the CCA. The left vagus nerve was positioned anteriorly, centrally, and posteriorly to IJV and common carotid artery in 10 (50%),2 (10%) and 5 (25%) of the specimens, respectively. In 2 (10%) specimens left vagus nerve was positioned posterior to IJV. In 1 (5%) specimen the vagus nerve was located posterior to CCA. Conclusion: In right and left anatomical relations between vagus nerve and vascular structures, considerable asymmetry was seen in anterior and middle positioning of vagus nerve. During CEA, taking this asymmetry into consideration is important to prevent possible cranial nerve injury complications.

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Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

Antipova,

Niedermair,

Siwetz

et al. 2023

Anatomical Sciences Ed

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Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol‐glycerin embalming. Between 2020 and 2022, first‐ and second‐year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel‐ and ethanol‐glycerin‐embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol‐glycerin‐embalmed specimens when compared to Thiel. No benefit was found for Thiel‐embalmed upper or lower extremities. Tissues embalmed with ethanol‐glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel‐embalmed tissues. Ethanol‐glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students’ ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.

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Positional Relations of the Cervical Vagus Nerve Revisited

Cited by 17 publications

References 48 publications

Sonographic evaluation of the vagus nerves: Protocol, reference values, and side‐to‐side differences

Sonographic evaluation of the vagus nerves: Protocol, reference values, and side‐to‐side differences

Vagus Nerve Injury During Carotid Endarterectomy: A Cadaveric Study

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

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