Morphological variability of the intercostobrachial nerve and potential surgical significance

Q3 Medicine

Morphologie Pub Date : 2025-02-12 DOI:10.1016/j.morpho.2025.100954

M. Piagkou , G. Triantafyllou , C. Koutserimpas , V. Ediaroglou , G. Tsakotos , C. Mariorakis , E. Anestiadou , K. Natsis

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引用次数: 0

Abstract

Background

The intercostobrachial nerve (ICBN) typically originates from the lateral cutaneous branch of the second intercostal nerve (T2). The ICBN may sometimes arise from the lateral cutaneous branch of T3. Many authors have undertaken ICBN studies as it is a highly variable structure with numerous morphological patterns reported. Variations include double-, triple-, and multiple ICBNs and their potential interconnections (ICs).

Aim

The current cadaveric study aims to explore the ICBN morphological variants, examining their origins, branching patterns, and relationships with adjacent vessels. Identifying neural variants closely correlates with arterial alterations and may reveal deviations in the ICBN typical course.

Materials and methods

Dissections were conducted on 30 (15 male and 15 female) formalin-embalmed Greek donated cadavers (60 sides in total) with an average age of 74.

Results

Forty-three out of sixty sides had typical ICBN anatomy (71.7%). ICBN variants were identified on 17/60 sides (11 unilateral [9 right and two left] and three bilateral cases) with an incidence of 28.3%. Concerning the ICBN morphology, a single ICBN existed on 9/60 sides (15%), two ICBNs (T2 and T3) on 3/60 sides (5%), three, four, and five, and multiple ICBNs on 1/60 sides (1.7%) per each. An ICBN division into two or three branches was identified on 3/60 sides (5%). ICBN interconnections (ICs) were identified with the medial brachial cutaneous nerve (MBCN) and the medial antebrachial cutaneous nerve (MACN) in 3 cases (5%) and 1 case (1.7%). ICs with the radial nerve (RN) were identified in 3 cases (5%) and ICs with both the MBCN and MACN in a unique case (1.7%). Arterial covariants were identified in 4 out of 60 cases (6.7%).

Conclusions

The current gross anatomy study emphasizes the clinical significance of preserving the ICBN during surgical procedures to prevent sensory loss or dysesthesia in the upper arm.

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肋间臂神经的形态变异及其潜在的外科意义

肋间臂神经（ICBN）通常起源于第二肋间神经（T2）的外侧皮支。ICBN有时可能起源于T3的外侧皮支。许多作者已经进行了ICBN研究，因为它是一个高度可变的结构，有许多形态模式的报道。变体包括双、三、多个icbn及其潜在的互连（ic）。目的本研究旨在探讨ICBN的形态变异，研究其起源、分支模式及其与邻近血管的关系。识别与动脉改变密切相关的神经变异，并可能揭示ICBN典型病程中的偏差。材料与方法对30具（男15具，女15具）希腊人捐赠的福尔马林防腐尸体（共60侧）进行解剖，平均年龄为74岁。结果60侧中43侧为典型ICBN解剖，占71.7%。在17/60侧发现ICBN变异（11例单侧[9例右侧，2例左侧]和3例双侧），发病率为28.3%。在ICBN形态方面，9/60面存在单个ICBN(15%)， 3/60面存在2个ICBN (T2和T3)(5%)， 3、4和5个ICBN， 1/60面存在多个ICBN（1.7%）。在3/60面（5%）确定了ICBN分为两个或三个分支。3例（5%）和1例（1.7%）分别与肱内侧皮神经（MBCN）和肱内侧前皮神经（MACN）连接。伴有桡神经（RN）的ic有3例（5%），同时伴有MBCN和MACN的ic有1例（1.7%）。60例中有4例（6.7%）发现动脉协变。结论目前的大体解剖学研究强调了在手术过程中保留ICBN以防止上臂感觉丧失或感觉不良的临床意义。

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

Morphologie Medicine-Anatomy

CiteScore

2.30

自引率

0.00%

发文量

150

审稿时长

25 days

期刊介绍： Morphologie est une revue universitaire avec une ouverture médicale qui sa adresse aux enseignants, aux étudiants, aux chercheurs et aux cliniciens en anatomie et en morphologie. Vous y trouverez les développements les plus actuels de votre spécialité, en France comme a international. Le objectif de Morphologie est d?offrir des lectures privilégiées sous forme de revues générales, d?articles originaux, de mises au point didactiques et de revues de la littérature, qui permettront notamment aux enseignants de optimiser leurs cours et aux spécialistes d?enrichir leurs connaissances.