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Surgical Anatomy of the Neck
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The prevertebral fascia encompasses the posterior neck muscles, the scalenes and the vertebrae. The alar fascia is a layer of fascia anterior to the prevertebral fascia, extending from the skull base to level of second thoracic vertebra.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The retropharyngeal space is situated posterior to the cervical viscera and anterior to the vertebrae. It extends from the basilar part of the occipital bone to the superior mediastinum and forms a dangerous route for the spread of infection from the pharyngeal wall down to the thorax. Lateral to this space is the sympathetic trunk. Along the trunk, swellings of the superior, middle, and inferior cervical sympathetic ganglia are found (often the inferior cervical ganglion and the 1st thoracic ganglion fuse into one stellate ganglion, or cervicothoracic ganglion). Gray rami communicantes connect these ganglia to the cervical spinal nerves. Superiorly, the internal carotid nerve carries postganglionic fibers from the superior cervical ganglion to all the structures of the head (Plate 3.20). The prevertebral fascia covers the prevertebral muscles (longus colli and longus capitis) and the lateral vertebral muscles (anterior, middle, and posterior scalene muscles).
Surgical Anatomy of the Neck
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Laura Warner, Christopher Jennings, John C. Watkinson
The prevertebral space is the potential area posterior to the prevertebral fascia and anterior to the vertebral column and para-spinal musculature. Spread of infection to this area may occur as a result of traumatic perforation of the pharynx or oesophagus, or because of a breach of prevertebral fascia from retropharyngeal infection. Infection in the prevertebral space can cause spinal osteomyelitis and spinal cord compression. Prevertebral space invasion in head and neck malignancy is a feature which often signifies inoperable disease.
Surgical treatment of T2-3 posterior hypopharyngeal carcinoma with preservation of laryngeal function
Published in Acta Oto-Laryngologica, 2021
Ling Chen, Yu Si, Peiliang Lin, Zhong Guan, Wenying Zhu, Haifeng Liang, Qian Cai
What are the reasons for the need of RFFF repair? The anatomical layers of posterior hypopharyngeal wall include mucosa, fibrous tissue, hypopharyngeal constrictor, prevertebral fascia and prevertebral muscle layer. Resection of posterior hypopharyngeal carcinoma often requires resecting hypopharyngeal muscle and exposing prevertebral fascia. If it is not repaired, mucosa at the entrance to the esophagus shrinks, and scarring and granulation appear, which can easily lead to esophageal stenosis. Through the repair of RFFF, the tension healing and scar stenosis caused by open position can be avoided. RFFF is undoubtedly a very good material. Repairing prevents infection, allows wounds to heal faster, and prevents esophageal stenosis and pharyngeal fistula. In our study, the RFFF was used to repair posterior wall of hypopharynx. After operation, all patients could take food through mouth and remove gastric tube. Swallowing function recovered well and none of patients had aspiration when eating solid food. However, because the flap lacks of sensation, swallowing time prolonged and 66.67% of patients had food residue. When taking liquid, 44.44% of patients did not have food entering the airway, 27.78% patients had food contacting the vocal folds, but could eject well, and none of patients had serious aspiration or even aspiration pneumonia.
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
The sympathetic chain is formed by a set of cervical ganglia and small fibers, also referred as sympathetic trunk. Although the sympathetic chain has an anatomical variability [58], most commonly is formed by a superior, middle, and inferior ganglion, as well as a stellate and vertebral ganglions. Superior, middle, and inferior ganglion are located at the level of the third, fifth and seventh cervical vertebra, respectively, whereas stellate and vertebral ganglia are related to the seventh cervical or first thoracic vertebra. Non infrequently, inferior cervical and stellate ganglion are fused [58]. The course of the sympathetic chain is oblique upward and laterally, under the prevertebral fascia. Its major axis forms an angle with the midline ranging between 10 and 11.5 degrees, and the distance of the inferior and superior ganglion from the medial border of the longus colli muscle measures 12.4 mm and 17.2 mm, respectively, on average [59,60]. The superior cervical ganglion is located above the longus capitis muscle and, at the level of C4/C5 disc, the sympathetic trunk crosses the line between the longus colli and longus capitis muscle.
Intraoperative Neuromonitoring and Lumbar Spinal Instrumentation: Indications and Utility
Published in The Neurodiagnostic Journal, 2021
Ryan C. Hofler, Richard G. Fessler
The typical approach to the anterior lumbar spine involves a retroperitoneal approach on the left side. For anterior lumbar interbody fusion (ALIF), an incision is made on the lower abdomen, and the rectus sheath is identified and incised. Gentle blunt dissection is carried out through the retroperitoneal space. A general surgeon or vascular surgeon often carries out the approach. As the intraperitoneal structures are dissected away from the surgical corridor, the ureter, psoas muscle, and iliac vein and artery are identified. These structures are handled with care to avoid injury. The vessels are retracted from the operating field, and the prevertebral fascia is incised to expose the vertebral bodies and disc space. Intraoperative fluoroscopy is used to ensure visualization of the levels of interest. From this point, discectomy with or without corpectomy can be carried out with care to avoid injury to the abdominal vasculature (Crock 1982; Mobbs et al. 2015; Rao et al. 2015). Typically, the epidural space is not entered via this approach. Implants, including cages, screws, and in some cases plates, are inserted in conjunction with bone graft material to complete the instrumentation and fusion.