The sternomastoid branch of the occipital artery: a surgical landmark for the spinal accessory nerve in selective neck dissections.
OBJECTIVE
To evaluate the anatomic relationship between the spinal accessory nerve (SAN) and the sternomastoid branch of the occipital artery (SBOA) and its utility as a surgical landmark during a selective neck dissection (SND).


METHODS
Consecutive patients undergoing SND for squamous cancer from October 1, 2004 to February 28, 2005 were enrolled in this study. During surgery the distance between the SBOA and the point of insertion of the SAN into the sternomastoid muscle (SMM) was measured.


RESULTS
Twenty-four patients underwent 33 SND. The distance between the SBOA and SAN ranged between 1 and 11 mm, with a mean of 6.2 mm and a median of 6 mm.


CONCLUSIONS
The relationship between these 2 structures has a range and constancy that is acceptable as a landmark.


CONCLUSIONS
This article presents a useful adjunct for location of the SAN in the anterior neck during SND.
Rafferty
Mark A
MA
University of Toronto, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada.
Goldstein
David P
DP
Brown
Dale H
DH
Irish
Jonathan C
JC
D000055:Accessory Nerve / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply*; D009333:Neck / Q000098:blood supply* / Q000294:innervation / Q000601:surgery; D037981:Neck Dissection / Q000379:methods*; D011446:Prospective Studies; D012782:Shoulder / Q000098:blood supply / Q000294:innervation; D014711:Vertebral Artery / Q000033:anatomy & histology*