Surgical anatomy of the spinal accessory nerve: is the great auricular point reliable?

Abstract

Objective: The study was to exam if the great auricular point is a dependable landmark for finding the spinal accessory nerve.

Design: A prospective study from January 2004 to August 2006 in a tertiary medical centre.

Setting: A tertiary medical centre, Tzu Chi General Hospital.

Methods: In the modified radical neck dissection, the topographic anatomy of spinal accessory was studied in 50 patients.

Main outcome: The great auricular point (GAP) was identified and the length of sternocleidomastoid muscle (SCM) below was measured. The distance between the spinal accessory nerve and the greater auricular point was measured.

Results: The ratio of the length of the SCM below the nerve exiting point to the total length of the muscle was near 0.66. The mean distance between the GAP and the accessory nerve was 0.92 cm (SD +/- 0.27).

Conclusions: The great auricular point is a reliable landmark for identification of the accessory nerve during the neck dissection.