1 University Hospitals of North Midlands NHS Trust, Stoke-On-Trent, UK.
Otolaryngol Head Neck Surg. 2018 Aug;159(2):300-302. doi: 10.1177/0194599818766057. Epub 2018 Mar 20.
Intraoperative identification of the spinal accessory nerve (SAN) is key in reducing nerve injury. This study aims to explore the surgical anatomy of the SAN and 2 landmarks for its identification-the sternocleidomastoid branch of the occipital artery (SBOA) and superior sternocleidomastoid tendon (SST)-to propose a novel method of identifying the SAN during surgical neck dissections. Twelve cadavers underwent bilateral level II-V neck dissection identifying the SAN, SBOA, and SST. Variation was documented and distance between landmarks and the SAN measured. The most common arrangement had the SST most superficially followed by the SBOA and then the SAN. The SAN was 3.63 ± 4.02 mm from the artery and 2.31 ± 1.72 mm from the tendon. A triangle-bordered by the tendon laterally, artery medially, and digastric muscle superiorly-contained the SAN in 95.8% of cases. This relationship translated into a reliable technique to identify the SAN intraoperatively, which has been used successfully in practice.
术中识别副神经 (SAN) 是减少神经损伤的关键。本研究旨在探讨 SAN 的手术解剖结构以及 2 个用于识别它的标志——枕动脉的胸锁乳突肌分支 (SBOA) 和胸锁乳突肌上肌腱 (SST)——提出一种在颈侧部解剖术中识别 SAN 的新方法。12 具尸体进行了双侧 II-V 颈部分区，以识别 SAN、SBOA 和 SST。记录了变异情况并测量了标志与 SAN 之间的距离。最常见的排列是 SST 最浅，其次是 SBOA，然后是 SAN。SAN 距动脉 3.63 ± 4.02mm，距肌腱 2.31 ± 1.72mm。由肌腱外侧、动脉内侧和二腹肌上方围成的三角形包含了 95.8%的 SAN。这种关系转化为一种可靠的术中识别 SAN 的技术，在实践中已成功应用。
