Anatomical mapping of the 4th intercostal nerve's lateral cutaneous branch in both sexes: implications for advanced breast Reconstruction.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2024-12-01 Epub Date: 2024-10-14 DOI:10.1007/s00276-024-03507-6

Alexander Gardetto, Romed Hörmann, Katharina Pfitscher, Marko Konschake, Hannes Stofferin

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引用次数: 0

Abstract

Purpose: This study aims to map the point of emergence of the lateral cutaneous branch of the fourth intercostal nerve in both sexes, addressing gaps in the current literature. The findings are intended to support surgeons in restoring breast function by providing precise anatomical data, regardless of the specific surgical technique employed.

Methods: An anatomical study was conducted using 50 sides from 25 formalin-preserved full-body donors, with equal representation of male and female subjects. Measurements were taken to determine the fascial point of emergence of the lateral cutaneous branch of the fourth intercostal nerve relative to the anterior axillary line and the transverse line. Multiple linear regression models were applied to evaluate the influence of variables such as sex, height, and side.

Results: Our findings indicate that the fascial point of emergence of the lateral cutaneous branch of the fourth intercostal nerve is consistently located within 20 to 24 mm relative to the transverse line in 37 (74%) cases, and within 4 to 10 mm relative to the anterior axillary line in 39 (78%) cases, regardless of sex, height, or side. The multiple linear regression analysis showed no significant correlation between these variables and the position of the point of emergence (p > 0.05).

Conclusion: These results provide surgeons with a practical tool for nerve coaptation during breast reconstruction, showing that sex and height do not affect the anatomical localization of the point of emergence. Precise knowledge of this point can improve surgical accuracy and enhance sensory recovery, leading to better patient outcomes.

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男女第四肋间神经外侧皮支的解剖图绘制：对晚期乳房重建术的影响。

目的：本研究旨在绘制男女第四肋间神经外侧皮支的起始点，填补现有文献的空白。研究结果旨在通过提供精确的解剖数据，帮助外科医生恢复乳房功能，无论采用何种具体的手术技术：方法：使用 25 位福尔马林保存的全身供体的 50 个侧面进行解剖研究，其中男性和女性受试者的比例相同。测量的目的是确定第四肋间神经外侧皮支相对于腋前线和横线的筋膜起始点。应用多元线性回归模型评估了性别、身高和体侧等变量的影响：结果：我们的研究结果表明，无论性别、身高或体侧如何，37 例（74%）病例的第四肋间神经外侧皮支的筋膜起始点始终位于相对于横线的 20 至 24 毫米范围内，39 例（78%）病例的第四肋间神经外侧皮支的筋膜起始点始终位于相对于腋前线的 4 至 10 毫米范围内。多元线性回归分析表明，这些变量与出血点位置之间没有显著相关性（P > 0.05）：这些结果为外科医生在乳房重建过程中进行神经吻合提供了一个实用工具，表明性别和身高不会影响出乳点的解剖定位。对该点的精确了解可提高手术的准确性并促进感觉恢复，从而改善患者的预后。

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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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.