When and why was the phrenicoabdominal branch of the left phrenic nerve placed into the esophageal hiatus in German textbooks of anatomy? An anatomical study on 400 specimens reevaluating its course through the diaphragm

Pretterklieber, Bettina; Hader, Maria; Hammer, Niels; Pryymachuk, Galyna; Pröls, Felicitas; Vielmuth, Franziska; Barnerssoi, Miriam; Cotofana, Sebastian; Custozzo, Amanda; Weyers, Imke; Wedel, Thilo; Arnold, Philipp; Rahner, Christoph; Müller‐Gerbl, Magdalena; Pretterklieber, Michael L.

doi:10.1016/j.aanat.2019.151415

Cited by 4 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding is sufficiently explained by the elevation of the diaphragm caused by the right-sided liver and due to the left position of the heart and the pericardium. Hence, the left phrenic nerve must follow an arc, whereas the right phrenic nerve is able to descend in an almost vertical direction to reach the diaphragm [ 22 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Phrenic Nerve Transfer to Musculocutaneous Nerve: An Anatomical and Histological Study

Fochtmann-Frana,

Pretterklieber,

Radtke

et al. 2023

Life

Self Cite

View full text Add to dashboard Cite

Background: To restore elbow flexor muscle function in case of traumatic brachial plexus avulsion, the phrenic nerve transfer to the musculocutaneous nerve has become part of clinical practice. The nerve transfer can be done by means of video-assisted thoracic surgery without nerve graft or via supraclavicular approach in combination with an autograft. This study focuses on a detailed microscopic and macroscopic examination of the phrenic nerve. It will allow a better interpretation of existing clinical results and, thus, serve as a basis for future clinical studies. Material and Methods: An anatomical study was conducted on 28 body donors of Caucasian origin (female n = 14, male n = 14). A sliding caliper and measuring tape were used to measure the diameter and length of the nerves. Sudan black staining was performed on 15 µm thick cryostat sections mounted on glass slides and the number of axons was determined by the ImageJ counting tool. In 23 individuals, the phrenic nerve could be examined on both sides. In 5 individuals, however, only one side was examined. Thus, a total of 51 nerves were examined. Results: The mean length of the left phrenic nerves (33 cm (29–38 cm)) was significantly longer compared to the mean length of the right phrenic nerves (30 cm (24–33 cm)) (p < 0.001). Accessory phrenic nerves were present in 9 of 51 (18%) phrenic nerves. The mean number of phrenic nerves axons at the level of the first intercostal space in body donors with a right accessory phrenic nerve was significantly greater compared to the mean number of phrenic nerves axons at the same level in body donors without a right accessory phrenic nerve (3145 (range, 2688–3877) vs. 2278 (range, 1558–3276)), p = 0.034. A negative correlation was registered between age and the nerve number of axons in left (0.742, p < 0.001) and right (−0.273, p = 0.197) phrenic nerves. The mean distance from the upper edge of the ventral ramus of the fourth cervical spinal nerve to the point of entrance of the musculocutaneous nerve between the two parts of the coracobrachialis muscle was 19 cm (range, 15–24 cm) for the right and 20 cm (range, 15–25 cm) for the left arm. Conclusions: If an accessory phrenic nerve is available, it presumably should be spared. Thus, in that case, a supraclavicular approach in combination with a nerve graft would probably be of advantage.

show abstract

Section: Discussionmentioning

confidence: 99%

Phrenic Nerve Transfer to Musculocutaneous Nerve: An Anatomical and Histological Study

Fochtmann-Frana,

Pretterklieber,

Radtke

et al. 2023

Life

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, marked lateral deviation and subsequent strain of the PN in the neck could increase the risk of nerve injury or nerve dysfunction [16]. Pretterklieber et al [18] described that left PN passed the diaphragm dorsal to the apex of the pericardium, though its passage is described as the oesophageal hiatus in many textbooks. In present case, left PN passed not the oesophageal hiatus but the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

An unusual anatomical variant of the left phrenic nerve encircling the transverse cervical artery

et al. 2021

View full text Add to dashboard Cite

show abstract

A meta-analysis on the anatomical variability of the brachial plexus: Part II — Branching of the supraclavicular part

Beneš

Kachlík

Belbl

et al. 2021

Annals of Anatomy - Anatomischer Anzeiger

View full text Add to dashboard Cite

When and why was the phrenicoabdominal branch of the left phrenic nerve placed into the esophageal hiatus in German textbooks of anatomy? An anatomical study on 400 specimens reevaluating its course through the diaphragm

Cited by 4 publications

References 22 publications

Phrenic Nerve Transfer to Musculocutaneous Nerve: An Anatomical and Histological Study

Phrenic Nerve Transfer to Musculocutaneous Nerve: An Anatomical and Histological Study

An unusual anatomical variant of the left phrenic nerve encircling the transverse cervical artery

A meta-analysis on the anatomical variability of the brachial plexus: Part II — Branching of the supraclavicular part

Contact Info

Product

Resources

About