title: Anastomoses between lower cranial and upper cervical nerves: a comprehensive review with potential significance during skull base and neck operations, part I: trigeminal, facial, and vestibulocochlear nerves.
abstract: Descriptions of the anatomy of the neural communications among the cranial nerves and their branches is lacking in the literature. Knowledge of the possible neural interconnections found among these nerves may prove useful to surgeons who operate in these regions to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections among the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized in two parts. Part I concerns the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches with any other nerve trunk or branch in the vicinity. Part II concerns the anastomoses among the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or among these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part I is presented in this article. An extensive anastomotic network exists among the lower cranial nerves. Knowledge of such neural intercommunications is important in diagnosing and treating patients with pathology of the skull base.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama; Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama; Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammadali M
authors.initials: MM
authors.lastname: Shoja
authors.forename: Nelson M
authors.initials: NM
authors.lastname: Oyesiku
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Griessenauer
authors.forename: Virginia
authors.initials: V
authors.lastname: Radcliff
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Chern
authors.forename: Brion
authors.initials: B
authors.lastname: Benninger
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Rozzelle
authors.forename: Ghaffar
authors.initials: G
authors.lastname: Shokouhi
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
mesh_terms: D001341:Autonomic Nervous System / Q000033:anatomy & histology; D002572:Cervical Plexus / Q000033:anatomy & histology*; D005154:Facial Nerve / Q000033:anatomy & histology* / Q000196:embryology; D006801:Humans; D009333:Neck / Q000294:innervation / Q000601:surgery; D019291:Skull Base / Q000294:innervation / Q000601:surgery; D014276:Trigeminal Nerve / Q000033:anatomy & histology* / Q000196:embryology; D000159:Vestibulocochlear Nerve / Q000033:anatomy & histology* / Q000196:embryology
keywords: anastomoses; anatomy; communicating; iatrogenic injury; skull base; surgery