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Identification of greater occipital nerve landmarks for the treatment of occipital neuralgia

100%

Loukas M., El-Sedfy A., Tubbs R. S., Louis R. G. J., Wartmann C. T., Curry B., Jordan R.

Folia Morphologica

2006

tom 65

nr 4

337-342

Important structures involved in the pathogenesis of occipital headache include the aponeurotic attachments of the trapezius and semispinalis capitis muscles to the occipital bone. The greater occipital nerve (GON) can become entrapped as it passes through these aponeuroses, causing symptoms of occipital neuralgia. The aim of this study was to identify topographic landmarks for accurate identification of GON, which might facilitate its anaesthetic blockade. The course and distribution of GON and its relation to the aponeuroses of the trapezius and semispinalis capitis were examined in 100 formalin-fixed adult cadavers. In addition, the relative position of the nerve on a horizontal line between the external occipital protuberance and the mastoid process, as well as between the mastoid processes was measured. The greater occipital nerve was found bilaterally in all specimens. It was located at a mean distance of 3.8 cm (range 1.5–7.5 cm) lateral to a vertical line through the external occipital protuberance and the spinous processes of the cervical vertebrae 2–7. It was also located approximately 41% of the distance along the intermastoid line (medial to a mastoid process) and 22% of the distance between the external occipital protuberance and the mastoid process. The location of GON for anaesthesia or any other neurosurgical procedure has been established as one thumb’s breadth lateral to the external occipital protuberance (2 cm laterally) and approximately at the base of the thumb nail (2 cm inferior). This is the first study proposing the use of landmarks in relation to anthropometric measurements. On the basis of these observations we propose a target zone for local anaesthetic injection that is based on easily identifiable landmarks and suggest that injection at this target point could be of benefit in the relief of occipital neuralgia.

A review of the tragal pointer: anatomy and its importance as a landmark in surgical procedures

100%

Muhleman M. A., Wartmann C. T., Hage R., Matusz P., Shoja M. M., Tubbs R. S., Loukas M.

Folia Morphologica

2012

tom 71

nr 2

The tragal pointer has long been used as a surgical landmark for the identification of the facial nerve trunk and the maxillary artery in such procedures as parotidectomy, internal fixation of subcondylar and condylar fractures, mandibular osteotomy, temporomandibular joint arthroplasty, and percutaneous blocks of branches of the trigeminal nerve and pterygopalatine ganglion. Aside from its use as an external landmark, it has also been implicated as a contributor to crease formation in the presence of peripheral arterial disease. This article will review the available literature on the tragal pointer’s use as an external landmark. (Folia Morphol 2012; 71, 2: 59–64)

Ograniczanie wyników

2 Folia Morphologica

2 Loukas M.

2 Tubbs R. S.

2 Wartmann C. T.

1 Curry B.

1 El-Sedfy A.

1 Hage R.

1 Jordan R.

1 Louis R. G. J.

1 Matusz P.

1 Muhleman M. A.

1 Shoja M. M.

1 2012

1 2006

Wyniki wyszukiwania

Identification of greater occipital nerve landmarks for the treatment of occipital neuralgia

A review of the tragal pointer: anatomy and its importance as a landmark in surgical procedures