The Craniocervical Nerve Plexus: A Microdissection Study
Abstract
The parapharyngeal space (PPS) is a region adjacent to the pharynx housing crucial structures including the last four cranial nerves (CN), upper cervical spinal nerves, superior cervical sympathetic ganglion (SCSG), jugular vein, and internal carotid artery. This study aims to elucidate the microanatomy of the understudied series of neural anastomoses in this space, the craniocervical nerve plexus (CCP). To expose the CCP, we performed gross and stereomicroscopic dissection on nine bisected heads, accessing the PPS laterally by removing the mandibular ramus and mastication muscles. To delineate the CCP, nerves were traced, and a composite drawing of the neural anastomoses was constructed. In all nine specimens, fusion of CNs X and XII was observed at the level of the C1 transverse process. Examination of CN X revealed the presence of a ganglion distal to the jugular foramen in four specimens. Connections were noted between the C1-C2 nerves and SCSG-CN XII. The carotid sinus received a variable number of branches; specifically, up to eight in one specimen, including contributions from CNs IX and X, the SCSG, and the superior laryngeal nerve. In six specimens, a connection between the pharyngeal branches of CNs IX and X was present. This study unveils the intricate anatomy of the CCP, which can be valuable for surgeons operating in this region. Fusion of CNs X and XII, sporadically reported as a rare finding, was found in all specimens. Further insight into the functional significance of these anastomoses can be gained through histological studies on nerve fiber composition.
Faculty Sponsors
Dr. Mohammadali Mohajel Shoja
Project Type
Event
Location
Alvin Sherman Library
Start Date
4-3-2024 12:30 PM
End Date
4-4-2024 1:30 PM
The Craniocervical Nerve Plexus: A Microdissection Study
Alvin Sherman Library
The parapharyngeal space (PPS) is a region adjacent to the pharynx housing crucial structures including the last four cranial nerves (CN), upper cervical spinal nerves, superior cervical sympathetic ganglion (SCSG), jugular vein, and internal carotid artery. This study aims to elucidate the microanatomy of the understudied series of neural anastomoses in this space, the craniocervical nerve plexus (CCP). To expose the CCP, we performed gross and stereomicroscopic dissection on nine bisected heads, accessing the PPS laterally by removing the mandibular ramus and mastication muscles. To delineate the CCP, nerves were traced, and a composite drawing of the neural anastomoses was constructed. In all nine specimens, fusion of CNs X and XII was observed at the level of the C1 transverse process. Examination of CN X revealed the presence of a ganglion distal to the jugular foramen in four specimens. Connections were noted between the C1-C2 nerves and SCSG-CN XII. The carotid sinus received a variable number of branches; specifically, up to eight in one specimen, including contributions from CNs IX and X, the SCSG, and the superior laryngeal nerve. In six specimens, a connection between the pharyngeal branches of CNs IX and X was present. This study unveils the intricate anatomy of the CCP, which can be valuable for surgeons operating in this region. Fusion of CNs X and XII, sporadically reported as a rare finding, was found in all specimens. Further insight into the functional significance of these anastomoses can be gained through histological studies on nerve fiber composition.
