Surgical “Safe Zone”: Rapid Anatomical Identification of the Lesser Occipital Nerve

• DOI: 10.1055/s-0038-1676601
• Publication Date: 2018-12-18T18:58:45Z
• Authors: Nima Khavanin; Hannah Carl; Robin Yang; Amir Dorafshar
• Keywords: Sternocleidomastoid muscle; Accessory nerve; Occipital neuralgia; Trapezius muscle

Background Surgical intervention has established a vital role in the management of chronic headaches. The lesser occipital nerve (LON) is common target patients suffering from neuralgia and often resected as first-line option. We endeavored to define relationships LON posterolateral neck facilitate its safe rapid intraoperative identification. Methods Seven fresh cadavers (14 nerves) were dissected, their mastoid prominence nearby spinal accessory (SAN) greater auricular noted. Results distance emergence along posterior sternocleidomastoid ranged 36 51 mm (mean: 45.2 mm), with relative symmetry between two nerves same cadaver. SAN emerged an average 54 prominence. Conclusion Exploration for should begin at point 40 border muscle. If exit not identified within 10 this exposure, our dissection continues cranially sternocleidomastoid, anterior trapezius. In rare cases may pierce fibers muscle ascend directly on top belly. By limiting caudal extend dissection, we can avoid exposure minimize risk iatrogenic injury.