Prevalence and anatomy of the axillary arch and its implications in surgical practice: A meta-analysis

The Five Diaphragms in Osteopathic Manipulative Medicine: Myofascial Relationships, Part 1

“…When the prevertebral fascia divides, it comes into contact with the epidural space (between the yellow ligament and the dura mater), creating another important dural contact site; the prevertebral fascia continues its work of connection between the tentorium cerebelli, the lingual complex, the thoracic outlet [35]. Through the ALL, the prevertebral fascia touches the suprapleural membrane or Sibson fascia, while laterally it merges with the fasciae of the axilla creating the axillary ligament or axillary arch or Langher arch [38]. The connective tissue that surrounds each structure not only brings together every anatomical aspect (solid and liquid fascia) but this fascial continuum allows the movement of the different structures and the transmission of innumerable biochemical and mechanometabolic messages [24].…”

A single‐center study on 12‐year experience in lymphadenectomy and in sentinel lymph node biopsy with 99m Tc‐labeled nanocolloid and indocyanine green as tracers: Relationships with detection and management of the Langer's axillary arch

“…This study stems from the need to provide the breast surgeon with a decision support system (DSS) along with information on tracers able to reduce the likelihood of failure due to Langer axillary arch (LAA) (Figure A‐C) in sentinel lymph node (SLN) biopsy (SLNB) and axillary lymph node dissection (ALND, lymphadenectomy) . The 99m Tc‐nanocolloidal albumin Nanocoll® (TcLC) at particle size range 3‐80 nm with a total dose of 200 µCi and intradermal 0.2‐0.3 mL injection was compared with indocyanine green (ICG) injected at 1.0 mL and used to guide dissection of lymph nodes (LNs) in the dark after 2.0‐3.0 minutes of breast massage.…”

“…A 2.7% occurrence of LAA (10 cases out of the 366 axillae—Table ) placed the incidence of such muscular variation in the bottom of detection range in clinical procedures . The muscle was fully described during lymphadenectomies (Table ): It originated proximally at the latissimus dorsi muscle level and distally adhered to the pectoralis major muscle tendon posterior side at the humeral insertion level (Figure D).…”

“…The muscle was fully described during lymphadenectomies (Table ): It originated proximally at the latissimus dorsi muscle level and distally adhered to the pectoralis major muscle tendon posterior side at the humeral insertion level (Figure D). These string‐like structures, recognized as complete arches, passed through the axillary cavity and were closely related to the axillary neurovascular bundle.…”

Accessory muscles of the anterior thoracic wall and axilla. Cadaveric, surgical and radiological incidence and clinical significance during breast and axillary surgery

“…The LAA or axillopectoral or dorsoepitrochlearis or pectorodorsalis muscle or Achselbogen of Langer extends from the anterior border of the latissimus dorsi muscle (LD) to the tendon of pectoralis major (PM) crossing the axilla and is relatively frequent among the accessory thoracic wall muscles having an incidence of 5.3% [77,79].…”