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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Lines of greatest tension in the neck are termed ‘relaxed skin tension lines’. The next layer is superficial cervical fascia, which consists of the adipose tissue and platysma. The deep cervical fascia surrounds the muscles and other structures of the neck to varying extent. The carotid sheath is a condensed part of deep fascia that encloses the structures like carotid arteries, vagus nerve and internal jugular vein. In health, the tissues within these spaces are either closely applied to each other or are filled with relatively loose connective tissue. However, they offer potential routes by which unchecked infection may spread within head and neck and between the face and the mediastinum.
Paediatric deep neck space infections
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
The two major fascial layers in the neck are the superficial cervical and deep cervical fascia. The superficial cervical fascia encloses platysma and surrounds the neck. The deep cervical fascia is divided into three layers – the superficial layer or investing fascia, the middle (pretracheal) layer and the deep (prevertebral) layer. The carotid sheath consists of fascia from all three deep layers and surrounds the common carotid artery, internal jugular vein and vagus nerve.
Neck Space Infections
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The cervical fascia invests muscles and organs of the neck thereby limiting and influencing the direction of spread of infection. The relationship of the fascial layers to each other and adjacent structures creates potential spaces and therefore understanding the anatomy of the cervical fascia is key to understanding the anatomy of neck space infections.
Lateral cervical approach for ventrally located upper cervical meningioma: experience of 14 cases with a narrative comparison with other surgical techniques
Published in International Journal of Neuroscience, 2022
Ali Ayyad, Mohammed Alhoobi, Ralf Kockro, Ahmed Shaaban, Gerd Kessel, Tareq Kanaan, Elias Dumour, Firas Hammadi, Raed Abu Jarir, Mohammed Maan Al-Salihi
The sternocleidomastoid and the splenius capitis muscles were cut just below the tip of the mastoid process, leaving enough cuff for re-suturing. The splenius capitis muscle was then reflected posteriorly, and the sternocleidomastoid muscle was reflected inferiorly and anteriorly. This allowed the spinal accessory nerve to identify as it enters the sternocleidomastoid, usually 3–4 cm below the mastoid process (Figure 4). The tips of transverse processes of C1, C2 & C3 were identified. The C1 transverse process was usually easy to palpate and located 1 cm below and 1 cm in front of the mastoid process, while the C2 transverse process was more difficult to palpate and could be confused with the C2–3 facet. Then, the deep cervical fascia was cut parallel to the course of the spinal accessory nerve from C1 downwards (Figure 4).
Radiofrequency ablation versus total thyroidectomy in patients with papillary thyroid microcarcinoma located in the isthmus: a retrospective cohort study
Published in International Journal of Hyperthermia, 2021
Qing Song, Hanjing Gao, Ling Ren, Xiaoqi Tian, Yu Lan, Lin Yan, Yukun Luo
TT was performed under general anesthesia by two experienced surgeons (both with >15 years of experience). A 6–8-cm-long transverse incision was made 2 cm above the sternal notch, and the thyroid was reached using an electro-scalpel. The deep cervical fascia was incised in the longitudinal direction, and the anterior fasciculus of the jugular vein was divided to expose the thyroid gland. TT was performed, and the capsule membrane was carefully stripped off. Lymphadenectomy in the central region of the thyroid was performed. Finally, a drainage tube was routinely preserved, and the incision was closed with a subcuticular suture. TSH suppression therapy (TSH was maintained at a relatively middle-lower level, 0.5–2.0 mU/L) was given to all patients to minimize the possibility of recurrence of cancer.
Comparison of ultrasound-guided percutaneous microwave ablation and parathyroidectomy for primary hyperparathyroidism
Published in International Journal of Hyperthermia, 2019
Fangyi Liu, Xiaoling Yu, Zhoulu Liu, Zhi Qiao, Jianping Dou, Zhigang Cheng, Zhiyu Han, Jie Yu, Ping Liang
Parathyroidectomy was performed under general anesthesia. After successful general anesthesia, the patient took a supine position, shoulder pillow, head back, routine disinfection and sterile sheet, and cloth was placed on both sides of the neck to fix. The upper two transverse fingers of sternal notch were taken and the collar transverse incision along the dermatoglyphic direction was about 5–8 cm. The skin, subcutaneous, latissimus cervicalis and superficial layer of deep cervical fascia were incised, and the incision was pulled up. The skin flaps were free between the loose connective tissue plane of latissimus cervicalis and deep cervical fascia, from the upper margin of thyroid cartilage to the sternal notch to fully expose the outer layer of deep cervical fascia. Lift the fascia on both sides of the median line, cut the white line of the neck and separate the gap between the subhyoid muscle group and the thyroid capsule with the finger to the front of the sternocleidomastoid muscle. The bilateral sternohyoid and thyroidal muscles were pulled apart to explore parathyroid tumors and to perform parathyroidectomy. The ipsilateral recurrent laryngeal nerve (RLN) was explored by nerve monitor to protect it intraoperatively. Hemostasis was fully achieved and the incision was sutured layer by layer.