Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, General Hospital Nuremberg, Nuremberg, Germany.
Folia Morphol (Warsz). 2023;82(3):513-518. doi: 10.5603/FM.a2022.0062. Epub 2022 Jun 27.
Cleidocervical muscles (CCM) or levator claviculae muscles in humans can be found as supernumerary unilaterally or bilaterally on the neck attached proximally to the clavicle and distally to the transverse process of cervical vertebrae at various levels. Altogether 20 case reports from year 1994 till present including 25 subjects related to CCM were found and analysed where parameters such as cervical insertion level, clavicular insertion at the middle vs. lateral third, unilateral vs. bilateral presence of the muscle, study type, reported gender of the subjects were extracted. Our literature survey shows that the prevalence of CCM in male and female was equally presented in radiological studies whereas almost 3-fold higher prevalence of males was found in cadaver reports. Since body donor system worldwide is male dominant, a 1:1 proportion of male and female in radiological studies could show more reality-based distribution of this muscle. Nevertheless, the presentation of this muscle was found in over 90% of the case reports unilaterally with higher left sided dominance. Even though the attachment points of CCM varied from case to case, the proximal attachment was found slightly more frequent on the middle third of the clavicle whereas the distal insertion was present more often on the superior cervical vertebrae than the lower ones. With prevalence of CCM in the population around 2.0-2.5%, the clinical, radiological and surgical relevance of this variation has to be highlighted to avoid potential misleading diagnostics in the neck.
人类的锁骨下肌(CCM)或斜方肌可在颈部单侧或双侧出现额外的肌束,起点靠近锁骨,止点位于颈椎的横突。1994 年至今,共发现并分析了 20 例相关病例报告,共涉及 25 例 CCM 患者,其中提取了颈部分叉的位置、锁骨中段或中外 1/3 附着、单侧或双侧出现、研究类型、报告的性别等参数。我们的文献综述显示,CCM 在男性和女性中的放射学研究中发生率相当,但在尸体报告中,男性的发生率几乎高出 3 倍。由于全球的尸体捐献系统以男性为主,因此在放射学研究中,男性和女性的比例为 1:1 可能更能反映出这种肌肉的真实分布情况。然而,在超过 90%的病例报告中,单侧出现 CCM 的情况更为常见,左侧更为多见。尽管 CCM 的附着点在不同病例中有所不同,但近端附着点更常见于锁骨中段,而远端附着点更常见于颈椎上部,而不是下部。由于 CCM 在人群中的患病率约为 2.0-2.5%,因此需要强调这种变异的临床、放射学和手术相关性,以避免在颈部出现潜在的误导性诊断。