Surgical Anatomy of the Spinal Accessory Nerve and the Trapezius Branches of the Cervical Plexus

Abstract

Background: A thorough understanding of the topographical anatomy of the spinal accessory nerve and the cervical plexus branches is a basic prerequisite for positive results when operating on the neck. Objective: To give an exact description of the topographical and surgical anatomy of the spinal accessory nerve (SAN) and the trapezius branches of the cervical plexus. Design: Anatomic analysis of the SAN and the trapezius branches of the cervical plexus. Setting: The topographical anatomy of the SAN and the cervical plexus branches were studied in the anterior and posterior triangles of the necks of 46 perfusion-fixed human cadavers of both sexes, which ranged in age from 55 to 97 years (mean age, 83 years). Results: The SAN can be identified on the posterior border of the sternocleidomastoid (SCM) muscle, 8.2±1.01 cm cranial to the clavicle. In 37% of cases, the SAN enters the posterior triangle of the neck dorsal to

Communication of the Anterior Branch of the Great Auricular Nerve with the Cervical Branch of Facial Nerve and its Variant Nerve Endings Deep in the Parotid Gland

“…In a recent study, this communication was found in 22 neck dissections (11 cadavers) and most of them were observed at the inferior border of submandibular gland (Domet et al, 2005). Communications between the cervical plexus and spinal accessory nerve are also well known and have been reported in the past (Soo et al, 1986;Kierner et al, 2000). Branches of cervical plexus rarely communicate with phrenic nerve (Loukas et al, 2006).…”

Communications of Transverse Cervical Cutaneous Nerve with the Cervical Branch of Facial Nerve and its Variant Nerve Endings Deep in the Parotid Gland

“…Communications between TCCN and the GAN as well as some cranial nerves usually exist and are reported in the past [1,3,4]. Biglioli et al [5] have been reported an anastomosis between the TCCN and anterior branch of GAN.…”

Dystonia and Peripheral Nerve Surgery in the Cervical Area

“…There are several nerves arising from this point, including the great auricular, lesser occipital, transverse cervical, and supraclavicular nerves (Anderson et al, 2008;Aramrattana et al, 2005;Dailiana et al, 2001). From the punctum nervosum, the accessory nerve courses inferolaterally, then ramifies into numerous branches supplying the trapezius (Aramrattana et al, 2005;Clemente, 1985;Dailiana et al, 2001;Kierner et al, 2000;Roman 1981;Shiozaki et al, 2000) (Fig.9). In addition to the accessory nerve, motor branches of the cervical plexus derived from the C2-C3 anterior rami participate in innervation of the sternocleidomastoid and trapezius muscles (Aramrattana et al, 2005;Bertrand, 2004;Clemente, 1985;Dailiana et al, 2001;Pu et al, 2008;Roman 1981;Stacey et al, 1995;Zhao et al, 2006).…”

“…The nerves which contribute to the innervation of cervical dystonic muscles are summarized in Table 3 ( Anderson et al, 2008;Aramrattana et al, 2005;Bertrand, 2004;Clemente, 1985;Dailiana et al, 2001;Frank et al, 1997;Kierner et al, 2000;Pu et al, 2008;Roman, 1981;Stacey et al, 1995;Taira, 2009;Zhao et al, 2006 Table 3. The muscles in the neck region associated with cervical dystonia and their nerve supply…”