Vagus Nerve's Topography in the Carotid Sheath: preliminary results

Abstract

The knowledge of the vagus nerve's location within the carotid sheath is essencial in many surgical contexts, such as thyroidectomy. Intraoperative neuromonitoring may prevent iatrogenic nerve injury. There are only few studies about vagus nerve and its topography in the carotid sheath. This study aims to analyze the variation of the vagus nerve topography and its relation with the common carotid artery and the internal jugular vein, at the infrahyoid region.We dissected 10 carotid sheaths from 5 cadavers and the position of the vagus nerve and its relationship with the common carotid artery and the internal jugular vein were determined. Based on the carotid sheath cross‐section, the location of the vagus nerve was classified in four quadrants: between the common carotid artery and the internal jugular vein, but anterior to the carotid artery's cross section (A), between the common carotid artery and the internal jugular vein, but posterior to the carotid artery's cross‐section (B), posterior and medial to the carotid artery's cross section (C) and posterior and lateral to the internal jugular vein's cross‐section (D).We found 6 vagus nerve in position (A), 1 in position (B), 0 in position (C) and 3 in position (D).The knowledge of variations and their prevalence regarding the position of the vagus nerve as described in this preliminary study may contribute to avoid iatrogenic lesions in cervical surgeries.