Connection types between the spinal root of the accessory nerve and the posterior roots of the C2–C6 spinal nerves
ABSTRACT The aim of this study was to demonstrate the connection types and frequency between the accessory nerve and the posterior roots of the C2-C6 cervical nerves.
The cranial cervical regions of 49 specimens from 27 human cadavers were used for the present study under an operating microscope.
Five different connection types between the accessory nerve and the posterior roots of the cervical nerves were recorded and photographed (types A-F). One of these types was not described previously in literature (type F). All connections between the posterior roots of the C2-C6 spinal nerves and the accessory nerve were at the level of the C2 segment. Type B was the most frequently seen type in our series. One of the rootlets of the cervical posterior root joined the accessory nerve without a connection to the spinal cord in type B.
The clinical importance of these connections is especially noticed during the radical neck dissection as it may lead to the development of the shoulder-arm syndrome.
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ABSTRACT: Aim: High cervical spinal cord injury is associated with high morbidity and mortality. Traditional treatments carry various complications such as infection, pacemaker failure and undesirable movement. Thus, a secure surgical strategy with fewer complications analogous to physiological ventilation is still required. We hope to offer one potential method to decrease the complications and improve survival qualities of patients from the aspect of anatomy. The purpose of the study is to provide anatomic details on the accessory nerve and phrenic nerve for neurotization in patients with high spinal cord injuries. Material and methods: 38 cadavers (76 accessory and 76 phrenic nerves) were dissected in the study. The width, length and thickness of each accessory nerve and phrenic nerve above clavicle were measured. The distances from several landmarks on accessory nerve to the origin and the end of the phrenic nerve above clavicle were measured too. Then, the number of motor nerve fibers on different sections of the nerves was calculated using the technique of immunohistochemistry. Results: The accessory nerves distal to its sternocleidomastoid muscular branches were 1.52 ± 0.32 mm ~1.54 ± 0.29 mm in width, 0.52 ± 0.18 mm ~ 0.56 ± 0.20mm in thickness and 9.52 ± 0.98 cm in length. And the phrenic nerves above clavicle were 1.44 ± 0.23 mm ~ 1.45 ± 0.24 mm in width, 0.47 ± 0.15 mm ~ 0.56 ± 0.25 mm in thickness and 6.48 ± 0.78 cm in length. The distance between the starting point of accessory nerve and phrenic nerve were 3.24 ± 1.17 cm, and the distance between the starting point of accessory nerve and the end of the phrenic nerve above clavicle were 8.72 ± 0.84 cm. The numbers of motor nerve fibers in accessory nerve were 1,038 ± 320~1,102 ± 216, before giving out the sternocleidomastoid muscular branches. The number of motor nerve fibers in the phrenic nerve was 911 ± 321~1,338 ± 467. Conclusion: The accessory nerve and the phrenic were similar in width, thickness and the number of motor nerve fibers. And the lengths of accessory nerve were long enough for neuritisation with phrenic nerve.Medical Hypotheses 02/2011; 76(4):564-6. DOI:10.1016/j.mehy.2011.01.001 · 1.07 Impact Factor
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ABSTRACT: With about 100,000 surgeries per year in Germany, thyroid operations count among the most common procedures performed in general and endocrine visceral surgery. Twentieth century technological development gives the opportunity to perform thyroid surgery without leaving visible scar like conventional approaches do. This study is part of the work on the videoendoscopic retro-auricular access to the thyroid gland using the EndoCATS method by Schardey and Schopf. To avoid possible complications with the spinal accessory nerve (SAN), like irritation or injury of the nerve as happened during a feasibility study, a systematic study of the surgical anatomy at the nerve's entry to the posterior cervical triangle is performed especially in relation to the EndoCATS operation method. Sixty-one neck regions in fifty-three specimens were examined at the anatomical institute of Munich to investigate the course of the SAN relative to the anatomic landmarks tip of mastoid bone, sternal notch, and posterior border of the sternocleidomastoid muscle together with the SAN's course variants at its entry to the posterior cervical triangle. The results were then statistically analyzed. From this analysis, we derived a simple method to predict the course of the SAN preoperatively and offer a new approach to protect the SAN during EndoCATS surgery. Additionally, we found a significant difference of the SAN's course between male and female specimens. The EndoCATS method can be a safe alternative to conventional thyroid surgery, but the SAN is at risk during the surgery procedure. Here we give feasible solutions to eliminate the SAN-problem performing EndoCATS thyroid surgery.Anatomia Clinica 07/2011; 33(8):703-11. DOI:10.1007/s00276-011-0845-3 · 1.05 Impact Factor
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ABSTRACT: Hyphenation of micro-liquid and ultra-performance liquid chromatography with a hybrid (QqTOF) tandem mass spectrometry was studied from the viewpoint of their applicability for monitoring of anthocyanin dyes in various cultivars and different vintages of red wine. After appropriate optimization both techniques proved to be suitable for this task. UHPLC system provided lower LOD and LOQ values as well as higher productivity and precision of retention parameters and peak areas with respect to micro-LC method. On the other hand, micro-LC method offers significant savings of mobile phase, less contamination of ion source of mass spectrometer and makes the nebulization process in electrospray much easier. In combination with principal component analysis (PCA), the method allows to elucidate long-term relations in a complete set of certified red wine cultivars grown in South Moravia (certified in Czech Republic until year 2005). Among the studied varieties Rubinet exhibit a specific anthocyanin profile. Especially interesting is a high content of 3-coumaroylglucoside-5-glucosides of malvidin and peonidin. Those dyes can be used as markers of artificial color enhancement. Principal component analysis applied to data processed with regard to enzymatic activity markedly facilitate classification among varieties. This approach allows resolution of teinturiers, variety Blaufränkish and partial classification of other varieties.Journal of Chromatography A 07/2011; 1218(42):7581-91. DOI:10.1016/j.chroma.2011.07.027 · 4.17 Impact Factor