14. Anatomical variations of cervical plexus in vietnamese adults

Vu Thanh Trung, Pham Duy Duc, Nguyen Van Diep, Doan Thi Nguyet, Doan Thi Nguyet Linh, Nguyen Viet Ngọc, Nguyen Van Huy

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Abstract

Understanding the anatomy of the cervical plexus is the basis for conducting applied studies in anesthesia, using skin flaps in head and neck surgery, and applying in plastic surgery in order to avoid injury to its branches which may cause postoperative loss of sensation. In this study, we describe different origins of branches from the cervical plexus. From data collected on 76 anterolateral cervical dissection specimens, we found many changes in the origin, branching and connection of the cervical plexus. The percentages of original forms of the branches of cervical plexus are as followed : the lesser occipital nerve is formed from C2: 48.68%, from C2 and C3: 26.32%, from C3: 14.47%, from loop 2: 7.89 %, from C1: 2.63%; the greater auricular nerve is formed from the combination of C2 and C3: 63.50%, from C2: 26.32%, from C3: 7.89%, from C3 and loop 3: 1.32%, from loop 1: 1.32%; The transverse cervical nerve is formed from C3: 38.16%, from C2 and C3: 30.26%, from C3 and C4: 22.37%, from C3 and loop 3: 6.58%, from loop 3: 6.58%, from loop 2: 1.32%; the supraclavicular nerve is formed from C4: 73.68%, from C3 and C4: 22.37%, from C3: 2.63%, from the loop 3: 1.32%; the phrenic nerve originates from C4: 30.14%, from C3 and C4: 23.29%, from C4 and C5: 23.29%, from C3 2.74%, from C3, C4 and C5: 20.55%. Accessory phrenic nerve, trapezius muscle branch and the branch (or branches) for sternocleidomastoid muscle were present at 5.97%, 89.47% and 51.32%, respectively. There were 5 types of ansa cervicalis.

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References

1. Sanjai Sangvichien. 2012 Anatomical variations of the superficial part of cervical plexus and branches in Thais. Siriraj Med, 2012, vol 64: S1 – S4.
2. Sanjai Sangvichien. (2003). Anatomical variations of the ansa cervicalis in Thais. Siriraj Medical Journal, vol 55(2), 91–99.
3. Mwachaka. Variation in the anatomy of ansa cervicalis. Folia Morphol, 2010, vol 69. 160-3.
4. A.D. Winnie, S. Ramamurthy, Z. Durrani, R. Radonjic. Intersscalene cervical plexus block a single – Injection technic. Anesthesia & Analgesia 54(3): p 370-375, May 1975.
5. A. Moya – Plana, C. Vacher. Lambeaux neuro cufanés appliqués à la chirugie cervicofaciale: estude anatomique de faisabilité à partirdes branches du plexus cervical superficiel. Morphologie, 2010, vol 94: 58 – 61.
6. Vũ Thanh An và Trần Minh Đạo 2009. Nghiên cứu đánh giá hiệu quả của gây tê đám rối thần kinh cổ nông bằng Lidocaine 1% trong mổ bướu giáp đơn thuần tại Viện 198. Tạp chí Y học thực hành, Số 6/2009. 39-43
7. Hoàng Văn Chương và Trần Đắc Tiệp 2011. Đánh giá hiệu quả vô cảm của phương pháp gây tê đám rối thần kinh cổ sâu hai bên bằng bupivcain 0,5% kết hợp với an thần bằng propofol theo kỹ thuật TCI trong phẫu thuật thoát vị đĩa đệm cột sống cổ theo đường trước bên. Tạp chí Y – Dược học Quân sự, số 36, 2011: 132 – 137.
8. Alonso Jose’l, Reis Roger G. Extracranial spinal accessery nerve palsy following neck surgery: A clinical and electrophysiological study of seven cases. ARQ. Neuro – psiquiatr. 2000, vol 58: 704 – 712. DOI:https://doi.org/10.1016/j.jhsa.2003.10.013.
9. Bertelli JA, MF Ghizoni. Reconstruction of C5 and C6 branchial plexus avulition injury by multiple nerve transfers: spinal accessory to suppras capular, ulnar fasciles to biceps branch, and triceps dragon or lateral head branch to axillary nerve. J. Hand Surg, 2004, 29A: 131 – 139. DOI: 10.1016/j.jhsa.2003.10.013.
10. Nunes Drisana R et al. Anatomical variation of sensory nerve branches of the cervical plexus. Int J Anat Res 2019, Vol 7(4.3): 7183-86. DOI: https://dx.doi.org/10.16965/ijar.2019.337.