Anatomical variations in the relationship between the spinal accessory nerve and internal jugular vein: a systematic review and meta-analysis |
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| Affiliation: | 1. Neurosciences Study Group, Federal University of Sergipe, São Cristóvão, Brazil;2. Nursing Department, Federal University of Sergipe, Aracaju, Brazil;3. Department of Morphology, Federal University of Sergipe, São Cristóvão, Brazil;1. Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China;3. Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China;4. Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;1. Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;2. Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel;1. Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China;2. Institute of Medical Technology, Peking University Health Science Center, Beijing, China;3. Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China;4. National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China;5. Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China;6. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China;1. Department of Burns and Plastic Surgery, University Hospital Brno, Brno, Czech Republic;2. Faculty of Medicine, Masaryk University, Brno, Czech Republic;3. Department of Maxillofacial Surgery, University Hospital Brno, Brno, Czech Republic;1. Department of Oral and Maxillofacial Surgery, 1st Faculty of Medicine and General University Hospital Prague, Praha, Czech Republic;2. Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic;3. Department of Composites and Carbon Materials, Institute of Rock Structure and Mechanics, Academy of Sciences of the Czech Republic, Prague, Czech Republic;1. University of Otago, School of Medicine, Wellington, New Zealand;2. Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA;3. Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia;4. World Health Organization Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Queensland, Australia;5. Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia;6. Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, Glasgow, UK;7. Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Victoria, Australia;8. Department of Oral and Maxillofacial Surgery, Townsville University Hospital, Queensland, Australia |
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| Abstract: | The relationship between the spinal accessory nerve and internal jugular vein is important for modified neck dissection surgery. Therefore, the aim of this review was to investigate variations in this relationship. Through a search of the PubMed, Scopus, Web of Science, LILACS, and SciELO databases, the review authors collected anatomical data for inclusion in a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four relationship patterns were identified and classified: type 1, the nerve lies superficial to the vein; type 2, the nerve lies deep to the vein; type 3, the nerve crosses the branches of the vein; type 4, the nerve splits and its branches pass around the vein. The last pattern was not included in the meta-analysis. Eighteen studies were included (useful sample of 1491 hemi-necks). Type 1 variation had a prevalence of 79.7% (95% CI 77.6–81.7%), type 2 had a prevalence of 19.6% (95% CI 17.7–21.7%), and the type 3 had a prevalence of 0.7% (95% CI 0.0–1.4%). Significant differences were found among geographical subgroups. Normally, the spinal accessory nerve passes superficial to the internal jugular vein, but anatomical variations are common and there is a geographical influence. These findings are important for the safety of modified radical neck dissections. |
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| Keywords: | accessory nerve neck dissection jugular veins anatomy surgical oncology meta-analysis |
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