Head and neck fascia and compartments: No space for spaces

Abstract

An accurate understanding of the arrangement of cervical fascia and its associated compartments is essential for differential diagnosis, predicting the spread of disease, and surgical management. The purpose of this detailed review is to summarize the anatomic, clinical, and radiological literature to determine what is known about the arrangement of cervical fascia and to highlight controversies and consensus. The current terminology used to describe cervical fascia and compartments is replete with confusing synonyms and inconsistencies, creating important interdisciplinary differences in understanding. The term "spaces" is inappropriate. A modified nomenclature underpinned by evidence-based anatomic and radiologic findings is proposed. This should not only enhance our understanding of cervical anatomy but also facilitate clearer interdisciplinary communication.

Terminologia Anatomica after 17 years: Inconsistencies, mistakes and new proposals

“…But one of the principal problems of anatomy and its precise terminology are the fasciae as already stated by Wendell-Smith (1997), Schleip et al (2012), Kumka and Bonar (2012), Guidera et al (2014) and Stecco et al (2013). From the morphological point of view, we lack a detailed and exact definition of fascia as a unit.…”

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“…Nevertheless, descriptions of regional cervical fascia remain challenged by inconsistencies of nomenclature [9]. Fortunately, more recent work appears to have addressed this by providing a coherent description of this fascia [19]. With the attribution of multiple physiological functions [20] and their attendant clinical implications [21][22][23] fascia has become a growing consideration in manual practice and its role in the Bow-string technique appears potentially significant.…”

Clinical and symptomatological reflections: the fascial system

“…The cervical tract has a fundamental importance for correct occlusion and postural balance; its dysfunction alters mastication and balance 80–83. The muscles involved in mastication, with opening and closing of the jaw, are surrounded by the cervical fascia: suprahyoid, masseteric, pterygoid, lingual and temporal muscles 84,85. We can reasonably assert that a dental disorder can directly originate in the thickening of the cervical fascial layers; in this event, a therapy merely aimed at restoring the functionality of the occlusion will be ineffective, if the cervical area is not treated.…”