Surgical Treatment of the Lesser Occipital Nerve

Abstract

The lesser occipital nerve (LON) is a spinal, purely sensory nerve that originates from the second and third cervical vertebrae. It is a branch of the cervical plexus and arises from the lateral branch of the ventral ramus of the second and third cervical nerves. Upon emerging from the spinal cord, the nerve pierces Erb’s point consistently cephalic to the great auricular nerve where it passes in relatively close proximity to the spinal accessory nerve. The lesser occipital nerve then typically travels between the fascia of the splenius muscle and the sternocleidomastoid muscle and ascends along the posterior border of the latter until it penetrates the deep fascia at the nuchal line to become more superficial. Cephalic to this point, the nerve travels within the subcutaneous tissues where it innervates an area of the scalp located behind the auricle and the lateral occipital region.