Journal of Surgery
Research Article
Anatomic Relationship between the Spinal Accessory Nerve and the Internal Jugular Vein in the Upper Neck during Neck Dissection: A Prospective Study
Rajan Govinda M1*, Bajarang PS1, Shyam TC1, Deepak P1, Sudeep M1, Paras RA1, Nimesh L2, and Durga N2
1Department of Otorhinolaryngology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
2Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
2Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
*Address for Correspondence:Rajan Govinda Mulmi, Department of Otorhinolaryngology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. E-mail: rajan_mulmi@yahoo.com
Submission:21 December, 2023
Accepted:08 February, 2024
Published:12 February, 2024
Copyright:©2024 Rajan Govinda M, et al. Powell BS, et al. This is
an open-access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium provided the original work is properly cited.
Keywords:Anatomy; Internal Jugular Vein; Spinal Accessory Nerve;
Anatomical Relationship; Prospective Study
Abstract
Objectives:To find the intraoperative relationship between the
spinal accessory nerve (SAN) and the internal jugular vein (IJV) in the
upper neck, at the level of the superior border of the posterior belly of
the digastric muscle.
Methods: A prospective study was carried out in the Department of Otorhinolaryngology and Head and Neck Surgery, B. P. Koirala Institute of Health Sciences, Dharan from December 2019 to November 2020.
Results:Thirty-nine patients were enrolled in the study who met the inclusion criteria. The mean age of the patient was 49.59 years with an SD of ±12.571 years. The age of the patients ranged from 17 to 70 years. The most common age group was 46 to 60 years (46.16%). The maximum number of patients were male which accounted for 32 (82.05%) and 7 (17.94%) were female. Unilateral neck dissections were done for 31 (79.48%) and bilateral neck dissections were done for 8 (20.51%) cases. The most common diagnosis for which neck dissections were carried out was carcinoma of the oral cavity (29 cases, 74.35%) followed by branchial cysts (4 cases, 10.25%), parotid neoplasms (4 cases, 10.25%) and thyroid neoplasms (2 cases, 5.12%).The SAN was positioned lateral to the IJV at the superior margin of the posterior belly of the digastric muscle in 35 (74.46%) of neck dissections, medial to the IJV at this level in nine cases (19.14%) and the SAN traveled directly through the IJV in three cases (6.38%).
Conclusion:The posterior belly of the digastric muscle is the most common location at which the SAN is encountered.
Methods: A prospective study was carried out in the Department of Otorhinolaryngology and Head and Neck Surgery, B. P. Koirala Institute of Health Sciences, Dharan from December 2019 to November 2020.
Results:Thirty-nine patients were enrolled in the study who met the inclusion criteria. The mean age of the patient was 49.59 years with an SD of ±12.571 years. The age of the patients ranged from 17 to 70 years. The most common age group was 46 to 60 years (46.16%). The maximum number of patients were male which accounted for 32 (82.05%) and 7 (17.94%) were female. Unilateral neck dissections were done for 31 (79.48%) and bilateral neck dissections were done for 8 (20.51%) cases. The most common diagnosis for which neck dissections were carried out was carcinoma of the oral cavity (29 cases, 74.35%) followed by branchial cysts (4 cases, 10.25%), parotid neoplasms (4 cases, 10.25%) and thyroid neoplasms (2 cases, 5.12%).The SAN was positioned lateral to the IJV at the superior margin of the posterior belly of the digastric muscle in 35 (74.46%) of neck dissections, medial to the IJV at this level in nine cases (19.14%) and the SAN traveled directly through the IJV in three cases (6.38%).
Conclusion:The posterior belly of the digastric muscle is the most common location at which the SAN is encountered.