The Posterior Triangle and Posterior Muscles of the Neck in 3-Dimensions: Creating a Digital Anatomic Model Using Peer-Reviewed Literature, Radiographic Imaging, and an Experienced Medical Illustrator.

Q4 Medicine
Mason Blue, Gabriela A Calcano, Dan C Schmidtman, Gabriel A Hernandez-Herrera, Emilyn P Frohn, Caitlin J Vander Wert, Kathryn M Van Abel, Jonathan M Morris, Linda X Yin
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引用次数: 0

Abstract

Introduction: The posterior cervical triangle houses an important nodal basin in the spread of several cancers in the head and neck, particularly cutaneous malignancies of the scalp. A safe and effective Level V neck dissection necessitates thorough understanding of the neurovascular structures housed within the region. Conventional 2D anatomical representations offer insights into the named structures, but fall short in illustrating the spatial relationships crucial in surgery. Here, we aim to develop an anatomically-precise 3D virtual model of the posterior cervical triangle and its constituent structures.

Methods: Musculature and neurovasculature were segmented from the computerized tomography (CT) angiogram of a healthy 29-year-old female. Literature review of cadaveric studies was performed to identify the most common variants, relevant surgical relationships, and usual dimensions of structures contained in the model. Structures unable to be visualized on imaging were created de novo using data obtained in the literature review. A medical illustrator then used this data to develop a 3D anatomical model using ZBrush.

Results: The musculature (sternocleidomastoid, trapezius, omohyoid, scalenes, erector spinae, and transversospinalis muscles) and neurovasculature (spinal accessory nerve, phrenic nerve, vertebral artery, subclavian artery, and brachial plexus) were characterized through literature review. Musculature and vasculature were segmented from CT angiography while neural structures were created de novo. Both radiographic and anatomic data were used to inform the creation of a 3D model, which will be uploaded to an online database for open access viewing.

Conclusions: A dynamic understanding of the spatial relationships existing among structures housed within the posterior triangle of the neck is imperative when operating in the region. The development of an accurate 3D anatomical model of such structures based upon predominant variants found in the literature will supplement the education of practicing and aspiring head and neck surgeons.

三维颈后三角和颈后肌肉:利用同行评议的文献、放射影像和经验丰富的医学插图画家创建数字解剖模型。
简介颈后三角区是头颈部多种癌症,尤其是头皮皮肤恶性肿瘤扩散的重要结节盆地。要安全有效地进行颈部五级解剖,就必须彻底了解该区域内的神经血管结构。传统的二维解剖图虽然能让人了解已命名的结构,但却无法说明手术中至关重要的空间关系。在此,我们旨在为颈椎后三角及其组成结构建立一个解剖精确的三维虚拟模型:肌肉和神经血管是从一名 29 岁健康女性的计算机断层扫描(CT)血管造影中分割出来的。对尸体研究进行了文献回顾,以确定最常见的变体、相关手术关系以及模型中所含结构的通常尺寸。利用文献综述中获得的数据,重新创建了无法通过成像观察到的结构。然后,一名医学插图画家利用这些数据使用 ZBrush 制作了一个三维解剖模型:结果:通过查阅文献,确定了肌肉组织(胸锁乳突肌、斜方肌、卵圆肌、头皮肌、竖脊肌和横纹肌)和神经血管(脊柱附属神经、膈神经、椎动脉、锁骨下动脉和臂丛神经)的特征。肌肉和血管是从 CT 血管造影中分割出来的,而神经结构则是重新创建的。放射学和解剖学数据都被用于三维模型的创建,该模型将被上传到在线数据库,供公开查阅:结论:在颈部后三角区域进行手术时,必须动态了解该区域内各结构之间存在的空间关系。根据文献中发现的主要变体建立此类结构的精确三维解剖模型,将为执业和有抱负的头颈部外科医生的教育提供补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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