Division of Macroscopical and Clinical Anatomy, Gottfried-Schatz Research Center, Medical University of Graz, Graz, Austria.
ENT University Hospital Graz, Medical University of Graz, Graz, Austria.
J Anat. 2020 Jul;237(1):197-207. doi: 10.1111/joa.13175. Epub 2020 Feb 20.
Due to varying descriptions and terminology of fascias of the neck, medical advice relying on this basic knowledge is insufficient. Our goal was to provide a precise anatomical description of cervical fascias and spaces with special focus on the intercarotid fascia, or the alar fascia. One hundred bodies donated to science embalmed with Thiel's method were investigated, cervical fascias were dissected layer by layer, and the results were documented by photography, with a focus on the intercarotid fascia. In addition, we performed a review of recent literature concerning cervical surgical interventions, radiological diagnostic pathways, and basic anatomical works focusing on core information on anatomical relations of cervical fascias and spaces. In another 10 bodies donated to science, the spaces of the neck were injected with coloured latex under ultrasound guidance, dissected, and documented by photography. The intercarotid fascia was a constantly developed connective tissue interconnecting the carotid sheath of both sides. In 52 of 100 specimens (52%) it crossed to the opposite side without any fusion to the ventrally situated visceral fascia. Fusion with the visceral fascia was found in 48%, either at the lateral border of the pharynx or on its dorsal side. The results of our dissections strengthen the precise description of the cervical fascias provided by Grodinsky and Holyoke in 1938. Spaces can be confirmed as described by Hafferl in 1969. The international anatomical and ENT societies should codify a unified anatomical terminology of the cervical spaces and fascias to prevent varying interpretations in the future.
由于颈部筋膜的描述和术语各不相同，因此仅依靠这一基础知识提供的医学建议是不够的。我们的目标是提供对颈部筋膜和间隙的精确解剖描述，特别关注颈动脉鞘之间的筋膜，或翼筋膜。我们对 100 具经蒂尔氏法防腐处理的捐赠给科学的尸体进行了研究，对颈部筋膜进行了逐层解剖，并通过摄影记录结果，重点关注颈动脉鞘之间的筋膜。此外，我们还对最近有关颈部外科干预、放射诊断途径以及基础解剖学的文献进行了综述，重点是关于颈部筋膜和间隙解剖关系的核心信息。在另外 10 具捐赠给科学的尸体中，我们在超声引导下将颈部间隙注入有色乳胶，然后进行解剖，并通过摄影记录结果。颈动脉鞘之间的筋膜是一种不断发育的结缔组织，连接着两侧的颈动脉鞘。在 100 个标本中的 52 个（52%）中，它没有与位于下方的内脏筋膜融合而跨越到对侧。融合发生在 48%的标本中，位于咽的外侧边界或其背侧。我们的解剖结果加强了 Grodinsky 和 Holyoke 于 1938 年对颈部筋膜的精确描述。Hafferl 于 1969 年描述的间隙可以得到证实。国际解剖学和耳鼻喉科协会应该对颈部空间和筋膜的解剖术语进行统一编码，以防止未来出现不同的解释。
