The Anatomy of the Extrathoracic Intercostobrachial Nerve

Abstract

The ICBN and its main branch (the posterior axillary nerve) were constant in all dissections. But its origin, size, connection to the brachial plexus and medial cutaneous nerve of the arm were variable, as was its ultimate destination in the arm.

The gross anatomy of the extrathoracic course of the intercostobrachial nerve

“…Similarly, and equally plausible, there is the possibility of absence of intrathoracic contributions of T2 to the brachial plexus, with the alternative that T2 may ultimately contribute to the brachial plexus extrathoracically. Further research into the specifics of the intrathoracic contribution (or lack thereof) of the T2 spinal nerve to the brachial plexus could potentially elucidate whether this observed communication in both our study and that of O'Rourke et al (1999) is a branching from the brachial plexus or to it.…”

“…Although they gave an excellent description of the intercostal origins of each of their variants, they provided no information regarding distribution patterns and gave no mention of branches anastomosing with the brachial plexus. O'Rourke et al (1999) performed an impressive analysis of the ICBN in 14 cadavers. They noted a contributing branch from the first intercostal nerve (in one specimen), as well as the third, whereas we observed no such contribution from the first space, but observed a branch from the fourth intercostal space in four axillae.…”

Intercostobrachial neuropathy due to axillary compression

“…It crosses the axilla and the medial side of the arm within the subcutaneous tissue supplying the skin of these regions. 7,9 The axilla is part of the T-1 and T-2, and perhaps T-3 dermatomes. 10 The ICBN is formed by T-2 fibers, but anatomically demonstrated connections suggest that it also carries fibers from T-1.…”

“…10 The ICBN is formed by T-2 fibers, but anatomically demonstrated connections suggest that it also carries fibers from T-1. 9 The T-2 root may also form the lower trunk of the brachial plexus. 10 This is possibly the largest sensory nerve in the body, and lesions occur often following surgeries for breast cancer and axillary lymphadenectomy.…”

Estudo morfológico da viabilidade do uso do nervo intercostobraquial como doador na restauração cirúrgica da sensibilidade da mão em portadores de lesões completas do plexo braquial

“…Como a dissecção do NICB teve o propósito de reproduzir as condições cirúrgicas de uma transferência para a CLNM, sua dissecação não foi prolongada distalmente em direção ao braço e foi limitada até que houvesse comprimento suficiente para que a técnica proposta fosse possível. Sendo assim, nem todas as comunicações deste nervo com outros do membro superior foram visibilizadas e descritas, como foram em outros estudos 13,19,21,22 . Outra limitação é o fato de se tratar de um estudo anatômico, não podendo fornecer ainda resultados funcionais de recuperação de sensibilidade.…”