Department of Anatomy, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Anatomy, Faculty of Medicine, Istanbul Health and Technology University, Seyitnizam, Mevlana St. No: 85, Zeytinburnu, Istanbul, 34015, Turkey.
Surg Radiol Anat. 2024 Dec;46(12):1917-1928. doi: 10.1007/s00276-024-03476-w. Epub 2024 Oct 17.
This study aims to reveal the relationship of the phrenic nerve (PhN) with its neighboring structures in the lower neck region more comprehensively than previous studies and to minimize nerve damage by enabling invasive procedures in this region to be performed with high accuracy.
Forty-one heminecks were evaluated. The relationship between the PhN and the anterior scalene muscle (ASM), internal thoracic artery (ITA), branches of subclavian artery (SA) and subclavian vein (SV) was examined.
It was observed that the PhN was located medial to the ASM in all cases. The distances were higher in male cadavers. The PhN was found to enter the thorax lateral to the ITA in 15/41 and medial to it in 25/41 sides. In 17/41 cases, the closest SA branch to the PhN was the thyrocervical trunk (TT) and in 24 cases the ITA. The PhN was located behind the SV in 38 cases and in front of it in 2 cases.The accessory PhN was found in 4/41 sides. There was no significant difference in morphometric findings between genders (p > 0.05). However, significant differences were observed between the parameters (p < 0.05).
The anatomy and variations of the PhN are of great importance in surgical interventions and invasive procedures in the neck region. The study provides important information to reduce the risk of damage to the PhN in surgical procedures. In addition, knowledge of the anatomical variations of the nerve may contribute to more successful results in nerve grafting and other surgical applications.
本研究旨在比以往研究更全面地揭示颈部下区膈神经(PhN)与其邻近结构的关系,并通过提高该区域的侵入性手术的准确性来最大限度地减少神经损伤。
评估了 41 个半颈。检查了 PhN 与前斜角肌(ASM)、胸廓内动脉(ITA)、锁骨下动脉(SA)和锁骨下静脉(SV)分支之间的关系。
所有病例中 PhN 均位于 ASM 内侧。男性尸体的距离更高。PhN 被发现有 15/41 例位于 ITA 外侧,25/41 例位于内侧进入胸腔。在 17/41 例中,最接近 PhN 的 SA 分支是颈肋干(TT),而在 24 例中是 ITA。PhN 位于 SV 后面的有 38 例,位于前面的有 2 例。在 4/41 例中发现了副膈神经。男女之间的形态学发现没有显著差异(p>0.05)。然而,参数之间存在显著差异(p<0.05)。
PhN 的解剖结构和变异在颈部手术干预和侵入性手术中非常重要。该研究为减少手术过程中对 PhN 损伤的风险提供了重要信息。此外,神经解剖变异的知识可能有助于神经移植和其他手术应用中取得更成功的结果。