一条新发现的颈丛无名神经的解剖与观察

Dissection and observation of a large unnamed nerve in the posterior cervical triangle

目的探查出现于颈后三角上部无名神经的解剖学特征及其与枕小神经的关系。方法 31具福尔马林固定的成人尸体头颈部标本,左侧和右侧,共62侧。按颈部常规切口,解剖和探查其颈外侧区、颈前区、胸锁乳突肌区、枕区。结果颈后三角上部无名神经的出现率高达96.8%。其主干(颈后三角段)直径约2～3 mm,长约10 cm,它起于第2颈神经前支(C2,C2-3),通过胸锁乳突肌上三分之一深面,至胸锁乳突肌后缘,位于副神经上方约1～3 cm,进入颈后三角,位置较深,然后靠近胸锁乳突肌后缘或与其平行上行,经过胸锁乳突肌和斜方肌在枕骨附着点之间进入枕区,分为3～5支,分布区域位于枕小和枕大神经皮肤分布区域之间。结论颈后三角上部有一条较大的无名神经通过,依据其形态学特征或应命名其为枕长神经。它的发现对此局部的外科手术以及有关疾病的诊断和治疗具有重要的意义。

Objective To characterize the anatomical features of a large unnamed nerve in the posterior cervical triangle and clarify its relationship with the lesser occipital nerve. Methods We dissected 31 adult formalin-fixed cadaver head and neck specimens（62 sides）. The lateral cervical region, the anterior cervical region, the sternocleidomastoid region, and the occipital region were dissected to define the anatomical features of the unnamed nerve. Results This unnamed nerve was identified in the posterior cervical triangle in 96.8% of the specimens. The main trunk of the nerve had a diameter of about 3 mm with a length of around 10 cm. The nerve arose from the anterior branch of the second cervical nerve（C2, C2-3）, entered the posterior cervical triangle at 1-3 cm above the accessory nerve, and continued to ascend along or in parallel with the posterior border of the sternocleidomastoid muscle. It passed between the attachments of the sternocleidomastoid and the trapezius to the occiput and divided into 3-5 branches, which innervated the skin area between the lesser and greater occipital nerves. Conclusions We identified a large unnamed nerve in the posterior cervical triangle, for which we coined the name ＂long occipital nerve＂ based on its unique anatomical features. The discovery of this nerve can be important for local surgery and for diagnosis and treatment of related diseases.