Abstract
In the current study, we display a rare association of an aberrant innervation of the sternocleidomastoid muscle by the ansa cervicalis (AC) with a tortuous common carotid artery (TCCA). In specific, in a male cadaver we observed on the right side of the cervical region, a nerval branch of remarkable size originating from the most distal part of the AC's superior root and after piercing the superior belly of the omohyoid muscle innervated the distal portion of the sternocleidomastoid muscle. Furthermore, we noticed a tortuous course of the initial part of the right common carotid artery. We discuss the surgical significance of the awareness of AC's variations during neurotisation of the recurrent laryngeal nerve in cases of its damage, as well as the importance of aberrant innervation of the sternocleidomastoid muscle by AC for the preservation of muscle's functionality after accessory nerve's damage. Furthermore, we highlight the fact, that the knowledge of the relatively uncommon variant, such as TCCA is crucial for the physician in order to proceed more effectively in differential diagnosis of a palpable mass of the anterior cervical region or deal with symptoms such as dyspnea, dysphagia or symptoms of cerebrovascular insufficiency.
Highlights
The ansa cervicalis (AC) or ansa hypoglossi as it is known is a cervical loop usually formed by first to third cervical nerves and innervating the infrahyoid muscles [1]
There is a variability in regards to the cervical nerves which participate in its formation, the length of the loop with respect to the omohyoid muscle, the variable morphology of the AC’s inferior root, the AC’s relationship to the internal jugular vein or the likely participation of the vagus nerve in AC formation [2]
We display a rare combination of an aberrant innervation of the sternocleidomastoid muscle by the AC, along with a tortuous common carotid artery (TCCA), which is an interesting opportunity to search through the literature for similar anatomical variations
Summary
The ansa cervicalis (AC) or ansa hypoglossi as it is known is a cervical loop usually formed by first to third cervical nerves and innervating the infrahyoid muscles [1]. We display a rare combination of an aberrant innervation of the sternocleidomastoid muscle by the AC, along with a TCCA, which is an interesting opportunity to search through the literature for similar anatomical variations. During the routine dissection of the neck in our Department of Anatomy in a 82-year-old male cadaver whose cause of death was unrelated to the current case study, an infrequent combination of an aberrant innervation of the sternocleidomastoid muscle by the AC along with TCCA was detected. After meticulous dissection of the anterior, as well, lateral cervical region we observed on the right side, a nerval branch of remarkable size originating from the most distal part of the AC’s superior root and. The detected nerval and vascular variations, along with their relationship to the adjacent anatomical elements were documented by photographs
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