Microsurgical Anatomy of the Hypoglossal and C1 Nerves: Description of a Previously Undescribed Branch to the Atlanto-Occipital Joint.

Autor: Iwanaga J; Seattle Science Foundation, Seattle, Washington, USA; Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan. Electronic address: joei@seattlesciencefoundation.org., Fisahn C; Seattle Science Foundation, Seattle, Washington, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA., Alonso F; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA., DiLorenzo D; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA., Grunert P; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA., Kline MT; Center for Pain Medicine, Bryn Mawr, Pennsylvania, USA., Watanabe K; Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan., Oskouian RJ; Seattle Science Foundation, Seattle, Washington, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA., Spinner RJ; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Tubbs RS; Seattle Science Foundation, Seattle, Washington, USA; Department of Anatomical Sciences, St. George's University, West Indies, Grenada.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2017 Apr; Vol. 100, pp. 590-593. Date of Electronic Publication: 2017 Jan 19.
DOI: 10.1016/j.wneu.2017.01.038
Abstrakt: Objective: Distal branches of the C1 nerve that travel with the hypoglossal nerve have been well investigated but relationships of C1 and the hypoglossal nerve near the skull base have not been described in detail. Therefore, the aim of this study was to investigate these small branches of the hypoglossal and first cervical nerves by anatomic dissection.
Methods: Twelve sides from 6 cadaveric specimens were used in this study. To elucidate the relationship among the hypoglossal, vagus, and first and cervical nerve, the mandible was removed and these nerves were dissected under the surgical microscope.
Results: A small branch was found to always arise from the dorsal aspect of the hypoglossal nerve at the level of the transverse process of the atlas and joined small branches from the first and second cervical nerves. The hypoglossal and C1 nerves formed a nerve plexus, which gave rise to branches to the rectus capitis anterior and rectus capitis lateralis muscles and the atlanto-occipital joint.
Conclusions: Improved knowledge of such articular branches might aid in the diagnosis and treatment of patients with pain derived from the atlanto-occipital joint. We believe this to be the first description of a branch of the hypoglossal nerve being involved in the innervation of this joint.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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