The Relationship of the Great Auricular Nerve to the Superficial Musculoaponeurotic System

McKinney, P.W.; Gottlieb, Jourdan R.

doi:10.1097/00000637-198504000-00003

Cited by 51 publications

(19 citation statements)

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“…The great auricular nerve is easily identified as it travels cranially on the investing fascia over the sternocleidomastoid muscle, parallel and posterior to the external jugular vein. 18,19 The nerve is then traced to its exit point at the posterior border of the sternocleidomastoid muscle-the great auricular point. Here, the other three cutaneous branches of the cervical plexus can be seen as they pierce the investing layer of the deep cervical fascia to become superficial.…”

Section: Surgical Techniquementioning

confidence: 99%

Surgical Approach to the Accessory Nerve in the Posterior Triangle of the Neck

Leung

Dieu

Cleland

2004

Plastic and Reconstructive Surgery

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Section: Surgical Techniquementioning

confidence: 99%

Surgical Approach to the Accessory Nerve in the Posterior Triangle of the Neck

Leung

Dieu

Cleland

2004

Plastic and Reconstructive Surgery

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“…The nerves of this area from lateral to medial are the lesser occipital nerve (LON), the greater occipital nerve (GON) (Arnold's nerve), and the third occipital nerve (TON) (least occipital nerve) (Barna and Hashmi, 2004). Most lateral, the great auricular nerve (GAN) may have a mastoid branch (McKinney and Gottlieb, 1985). Rarely, the suboccipital nerve (dorsal ramus of C1) which normally innervates primarily the muscles of the suboccipital triangle sends a small cutaneous filament to the occiput (Bogduk, 1982).…”

Section: Introductionmentioning

confidence: 99%

Landmarks for the identification of the cutaneous nerves of the occiput and nuchal regions

et al. 2006

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Although surgical procedures are often performed over the posterior head and neck, surgical landmarks for avoiding the cutaneous nerves in this region are surprisingly lacking in the literature. Twelve adult cadaveric specimens underwent dissection of the cutaneous nerves overlying the posterior head and neck, and mensuration was made between these structures and easily identifiable surrounding bony landmarks. All specimens were found to have a third occipital nerve (TON), lesser occipital nerve (LON), and greater occipital nerve (GON), and we found that the TON was, on average, 3 mm lateral to the external occipital protuberance (EOP). Small branches were found to cross the midline and communicate with the contralateral TON inferior to the EOP in the majority of sides. The mean diameter of the main TON trunk was 1.3 mm. This trunk became subcutaneous at a mean of 6 cm inferior to the EOP. The GON was found to lie at a mean distance of 4 cm lateral to the EOP. On all but three sides, a small medial branch was found that ran medially from the GON to the TON approximately 1 cm superior to a horizontal line drawn through the EOP. The GON was found to pierce the semispinalis capitis muscle on average 2 cm superior to the intermastoid line. The mean diameter of the GON was 3.5 mm. The GON was found to branch into medial and lateral branches on average 0.5 cm superior to the EOP. The LON was found to branch into a medial and lateral component at approximately the midpoint between a horizontal line drawn through the EOP and the intermastoid line. The main LON trunk was found on average 7 cm lateral to the EOP. In specimens with a mastoid branch of the great auricular nerve (GAN), this branch was found at a mean of 9 cm lateral to the EOP. The main trunk of this branch of the GAN was found to lie on average 1 cm superior to the mastoid tip. Easily identifiable bony landmarks for identification of the cutaneous nerves over the posterior head and neck can aid the surgeon in more precisely identifying these structures and avoiding complications. Although the occipital nerves were found to freely communicate with one another, avoiding the main nerve trunks could lessen postoperative or postprocedural morbidity. Moreover, clinicians who need to localize the occipital nerves for the treatment of occipital neuralgia could do so more reliably with better external landmarks.

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“…[2][3][4][5] Articles by McKinney and Katrana, 2 Izquierdo et al, 4 and Sand and Becser 8 have defined absolute measurements that can be used to predict the location of the GAN, but these estimates can vary greatly depending on the size and body habitus of individual patients.…”

mentioning

confidence: 99%