The extracranial head and neck

Cervical fascia: a terminological pain in the neck

“…Its deeper part includes the platysma muscle in the neck, the muscles of facial expression in the face and occipitofrontalis in the scalp. This description was consistent with most textbook descriptions, but some texts preferred the terms subcutaneous tissue or fat, emphasizing that this layer has ‘no resemblance to other so‐called deep fasciae’ . Plastic and reconstructive surgery texts tended to discuss this layer in relation to facelift surgery and regarded it as synonymous with or part of the superficial musculoaponeurotic system in the face, often referring to it as the ‘platysmal layer’ in the neck…”

“…As these descriptions appear in several chapters spanning the face, pharynx and neck, indices were checked for all references and, in the case of online books, individual terms were entered into the search function. Accounts were compared with descriptions given by Grodinsky and Holyoke, and with two contemporary anatomical texts, Gray's Anatomy (a definitive reference text) and Gray's Anatomy for Students (a popular undergraduate text) …”

“…All texts referred to this layer as either the prevertebral fascia or deep layer of deep cervical fascia (DLDCF) often using the terms interchangeably. There were two main points of confusion: The existence of a separate layer of the DLDCF anteriorly between the transverse processes (alar fascia).…”

“…Some authors suggested that the DLDCF be renamed the paravertebral or paraspinal layer to reflect its posterolateral extension. There was disagreement about the caudal extent of the DLDCF, with some texts stating that it extends to the coccyx, while others describing it ending at T3, in the mediastinum, or simply the chest…”

“…Inferiorly, it communicates with the submandibular space. When mentioned in the recommended texts, it was, with few exceptions, almost always called the parapharyngeal space . Many texts describe the subdivision of this space by tensor veli palatini fascia into pre‐ and poststyloid (retrostyloid) regions .…”