Anastomoses (Superficial Cervical Ansa) Between the Cervical Plexus and Peripheral Facial Nerve Branches: Implications for Regional Anesthesia in Carotid Endarterectomies - Anatomical Study.

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2021-10-13 eCollection Date: 2021-01-01 DOI:10.2147/LRA.S328987
Ronald Seidel, Andreas Wree, Marko Schulze
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Abstract

Purpose: Sensory innervation in the carotid triangle involves the cervical plexus, cranial nerves, and the sympathetic trunk. This innervation also applies to skin incision, including various anatomical structures with potentially different innervation, such as the skin (dermatomes), the platysma (myotomes), and the superficial layer of the cervical fascia (fasciotomes), as well as retromandibular retractor insertion (co-innervation: V, VII). The aim of this anatomical study was to develop an injection technique for carotid endarterectomies to additionally block anastomoses between the transverse cervical nerve (TCN), the cervical branch VII (CB VII), and the marginal mandibular branch VII (MMB VII). These anastomoses are also termed superficial cervical ansa (SCA).

Materials and methods: Preparations (n=16) were performed on unembalmed donor cadavers (n=8). Subplatysmal injections (each using 5 mL of Alcian blue) were performed cranially within the carotid triangle between the anterior margin of the sternocleidomastoid muscle and the submandibular gland.

Results: Anastomoses between the TCN, CB VII, and MMB VII were stained in all preparations (n=16).

Conclusion: This anatomical study presents an ultrasound-guided subplatysmal SCA block to optimize, in addition to a cervical plexus block, the quality of anesthesia for carotid endarterectomies.

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颈丛与周围面神经分支之间的吻合口(颈浅Ansa):颈动脉内膜切除术中区域麻醉的意义-解剖学研究。
目的:颈动脉三角的感觉神经支配包括颈丛、颅神经和交感神经干。这种神经支配也适用于皮肤切口,包括各种可能有不同神经支配的解剖结构,如皮肤(皮节)、阔阔肌(肌节)和颈筋膜浅层(筋膜节),以及下颌后牵开器的插入(共神经支配:这项解剖学研究的目的是开发一种用于颈动脉内膜切除术的注射技术,以额外阻断颈横神经(TCN)、颈VII支(CB VII)和下颌边缘支VII (MMB VII)之间的吻合,这些吻合也被称为颈浅ansa (SCA)。材料与方法:对8具未防腐处理的供尸进行制备(n=16)。在胸锁乳突肌前缘和颌下腺之间的颈动脉三角内进行颅侧颈动脉下注射(每次使用5ml阿利新蓝)。结果:所有制剂均有TCN、cbvii、MMB VII吻合口染色(n=16)。结论:本解剖研究提出了超声引导下的颈颈动脉内膜下SCA阻滞,除了颈丛阻滞外,还可以优化颈动脉内膜切除术的麻醉质量。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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