Surgical and Radiologic Anatomy最新文献

{"title":"A bilateral cervical accessory biceps muscle: anatomical description and clinical implications.","authors":"Maria Luísa Rodrigues Oliveira Roque, Lorenzo Ribeiro Dias Vieira, Alice Viçosi da Silva, Josemberg da Silva Baptista","doi":"10.1007/s00276-026-04038-y","DOIUrl":"10.1007/s00276-026-04038-y","url":null,"abstract":"<p><strong>Purpose: </strong>Accessory muscles between the levator scapulae and serratus posterior superior are rarely reported and may be interpreted as variants of either adjacent muscle. This study describes bilateral accessory muscles in the posterior cervical and upper thoracic region and discusses their anatomical classification and clinical relevance.</p><p><strong>Methods: </strong>A routine anatomical dissection was performed in a formalin-fixed adult male cadaver. The posterior cervical and upper thoracic regions were dissected to define the topography, attachments, morphology, distal interface, and innervation of the accessory muscles. Morphometric measurements were obtained bilaterally using a caliper.</p><p><strong>Results: </strong>Bilateral elongated muscular structures were identified between the levator scapulae and serratus posterior superior muscles. Each muscle had an individual proximal attachment at the transverse process of the second cervical vertebra, followed an inferomedial course approximately parallel to the splenius capitis, and remained distinct from the main belly of the levator scapulae. Distally, each muscle was separated from the serratus posterior superior by a bursal interface, without direct muscular or aponeurotic continuity or independent scapular insertion. Both muscles were bicipital and fusiform and were innervated by posterior rami that also supplied the splenius capitis.</p><p><strong>Conclusion: </strong>These findings support the interpretation of the structures as paired individualized accessory muscles rather than accessory slips of adjacent muscles, expanding the known spectrum of posterior cervical and upper thoracic anatomical variations.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare origin of the right inferior phrenic artery from the anterior inferior pancreaticoduodenal artery in a patient with hepatocellular carcinoma.","authors":"Kotaro Hosoi, Tomoya Matsumoto, Yu Fujiki, Naoyuki Takahashi, Go Suzuki, Mitsuhiro Narata, Masahito Karikomi, Hirokazu Saigusa, Yasutaka Naoe","doi":"10.1007/s00276-026-04034-2","DOIUrl":"10.1007/s00276-026-04034-2","url":null,"abstract":"<p><p>The inferior phrenic arteries show considerable variation in their origins. We describe a rare origin of the right inferior phrenic artery (RIPA) from the anterior inferior pancreaticoduodenal artery (AIPDA) in a patient with ruptured hepatocellular carcinoma (HCC), identified by contrast-enhanced computed tomography (CT) and angiography, and discuss its anatomical and clinical significance. A woman in her 80s underwent emergency transcatheter arterial embolization for ruptured HCC. Preprocedural contrast-enhanced CT did not identify the origin of the RIPA at its usual sites but suggested that it arose from the superior mesenteric arterial system and provided additional supply to the HCC, which was predominantly supplied by the right hepatic artery. Right hepatic arteriography demonstrated tumor staining and intratumoral contrast extravasation; however, a portion of the tumor remained unstained, suggesting extrahepatic arterial supply. The hepatic arterial branches were subsequently embolized with gelatin sponge particles. Superior mesenteric arteriography and selective inferior pancreaticoduodenal arteriography demonstrated that the RIPA arose directly from the AIPDA. Selective RIPA arteriography confirmed additional tumor supply from this vessel and demonstrated a branch arising from its anterior division that crossed the midline toward the left subdiaphragmatic region, consistent with a left inferior phrenic arterial branch. The RIPA was embolized with gelatin sponge particles, resulting in disappearance of tumor staining. The patient remained hemodynamically stable and was transferred the following day. The RIPA may rarely arise directly from the AIPDA. This case expands the known spectrum of inferior phrenic arterial origins and highlights the anatomical and clinical significance of recognizing this variation.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional anatomical classification and machine learning prediction of the P6a-right hepatic vein relationship: surgical implications for laparoscopic right anterior sectionectomy.","authors":"Haoming Li, Chengli Liu, Jingchen Zhang, Hao Huang, Meng Pu, Yingbo Ma, Linghong Kong","doi":"10.1007/s00276-026-04016-4","DOIUrl":"https://doi.org/10.1007/s00276-026-04016-4","url":null,"abstract":"<p><strong>Background: </strong>The spatial relationship between the ventral branch of segment VI portal vein (P6a) and the right hepatic vein (RHV) significantly influences the anatomical complexity of the right hepatic fissure and the surgical outcomes of laparoscopic right anterior sectionectomy (LRAS). The ventral-P6a variant is often associated with higher surgical risks, yet preoperative prediction remains challenging.</p><p><strong>Methods: </strong>This retrospective study included 100 patients who underwent triple-phase enhanced CT of the upper abdomen. Based on three-dimensional reconstructions, P6a was classified as dorsal or ventral relative to the RHV according to its anatomical relationship. Five machine learning models-logistic regression, random forest, K-nearest neighbors, support vector machine, and XGBoost-were employed to predict P6a classification using anatomical angular and linear measurements. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and the F1-score, and the SHAP method was applied for feature interpretation.</p><p><strong>Results: </strong>Among the 100 patients, 59% were classified as dorsal-P6a and 41% as ventral-P6a. The ventral-P6a group exhibited a significantly smaller angle between the anterior and posterior portal branches (82.27° vs. 98.02°, P = 0.003), a higher proportion with a distance of less than 5 mm from the P6a origin to the posterior branch origin (37% vs. 10%, P = 0.001), and a larger RHV-inferior vena cava angle (52.23° vs. 43.97°, P = 0.013). The logistic regression model demonstrated the best performance in the test set (F1-score = 0.741) with minimal overfitting. The most important predictive features included the angle between the anterior and posterior portal branches, the angle of the right hepatic fissure plane, and the diameter of P6a. SHAP analysis validated the interpretability of the model.</p><p><strong>Conclusion: </strong>A machine learning model based on three-dimensional imaging anatomical features can effectively predict the spatial classification of P6a relative to the RHV. The interpretable logistic regression model identifies key anatomical risk factors, providing a basis for preoperative risk assessment and surgical planning in LRAS, particularly for optimizing surgical strategies in high-risk patients with the ventral-P6a variant.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between thoracic kyphosis and sternoclavicular and scapulothoracic alignment: a cross-sectional opportunistic thoracic CT study.","authors":"Suat Kamil Süt, Yusuf Jamil, Sinem Nur Sever, Furkan Nalbant, Emre Demir, Hale Oktem","doi":"10.1007/s00276-026-04028-0","DOIUrl":"https://doi.org/10.1007/s00276-026-04028-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the cross-sectional association between thoracic kyphosis and static shoulder-girdle alignment on opportunistic thoracic computed tomography (CT), with particular emphasis on scapular orientation and anterior sternoclavicular (SC) joint positioning.</p><p><strong>Methods: </strong>This single-centre retrospective study included 215 adults undergoing thoracic CT between January 2025 and February 2026. Upper (T1-T5), lower (T5-T12), and measured total (T1-T12) thoracic kyphosis were assessed alongside scapular, clavicular, and SC joint parameters. Associations were examined using Spearman correlation, multivariable linear regression, and parsimonious logistic regression. Inter-rater reliability was assessed in 30 examinations.</p><p><strong>Results: </strong>Mean age was 52.5 ± 15.8 years, and 27 patients (12.6%) demonstrated anterior SC positioning. Greater total T1-T12 kyphosis correlated with smaller bilateral mean scapular plane angle (r = - 0.291, p < 0.001). In multivariable analysis, both T1-T5 (β = -0.267, p < 0.001) and T5-T12 kyphosis (β = -0.130, p = 0.024) were independently associated with smaller scapular plane angles. T1-T5 kyphosis was independently associated with anterior SC positioning (OR 1.080 per degree, 95% CI 1.021-1.141; p = 0.007), while total T1-T12 kyphosis was also associated (OR 1.043, 95% CI 1.002-1.086; p = 0.040). Inter-rater reliability was excellent (ICC 0.962-0.999).</p><p><strong>Conclusion: </strong>Greater thoracic kyphosis on supine thoracic CT was associated with altered static shoulder-girdle alignment, particularly greater scapular protraction and anterior SC positioning. Upper thoracic curvature showed the most consistent association with anterior SC position. These findings highlight the potential value of thoracic CT for characterizing clinically relevant shoulder-girdle alignment patterns and provide a foundation for future prospective and functional studies.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of masseter and temporalis muscle properties in healthy young adults using shear wave elastography and MyotonPRO.","authors":"Aslıhan Artaş, Firdevs Aşantoğrol, Zübeyde Uçar Gündoğar, Zeynep Şencan, Ceyda Şevval Çetin, Rümeysa İnce, Orhan Beger, Ömer Faruk Cihan, Fatih Sarı","doi":"10.1007/s00276-026-04030-6","DOIUrl":"10.1007/s00276-026-04030-6","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the relationship between stiffness measurements obtained using shear wave elastography (SWE) and MyotonPRO (MPRO) within the same muscle and functional state, and to establish sample-specific baseline values for the masseter and temporalis muscles in healthy young adults aged 19-29 years under standardized resting and contraction conditions.</p><p><strong>Methods: </strong>In this cross-sectional study, 100 healthy young adults aged 19-29 years were included. For analytical consistency, MPRO stiffness values were abbreviated as MR-S, MC-S, TR-S, and TC-S, representing the masseter at rest, masseter during contraction, temporalis at rest, and temporalis during contraction, respectively; the corresponding SWE measurements were denoted as MR-SWE, MC-SWE, TR-SWE, and TC-SWE. Holm correction was applied across the 120 correlation tests to account for multiple testing.</p><p><strong>Results: </strong>No significant correlation was found between SWE- and MPRO-derived stiffness values for the masseter or temporalis muscles under resting conditions (MR-S vs. MR-SWE, Holm-adjusted p = 1.000, r = 0.065; TR-S vs. TR-SWE, Holm-adjusted p = 1.000, r = -0.100). During contraction, a weak positive correlation was observed for the masseter muscle (MC-S vs. MC-SWE, Holm-adjusted p = 0.012, r = 0.268), whereas the very weak correlation for the temporalis muscle was no longer statistically significant after correction (TC-S vs. TC-SWE, Holm-adjusted p = 1.000, r = 0.141). Standardized comparison using z-scores showed no significant differences between the two methods for either muscle at rest or during contraction (MR, p = 0.872; TR, p = 0.607; MC, p = 0.608; TC, p = 0.697).</p><p><strong>Conclusions: </strong>Although standardized z-score comparisons showed no significant group-level differences between SWE and MPRO, the absence of significant correlations at rest and the presence of a significant but weak correlation only for the masseter during contraction after Holm correction indicate limited individual-level correspondence between the two methods. These findings suggest that SWE and MPRO may provide complementary rather than directly interchangeable information on masticatory muscle properties.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The axillary vein and its tributaries: anatomical variations, morphometry, and surgical implications.","authors":"Elif Cansu İbiş, Ahmet Ertaş, Büşra Yıldız, Kıvanç Goral, Mahmut Ercan Tanyeli","doi":"10.1007/s00276-026-04026-2","DOIUrl":"10.1007/s00276-026-04026-2","url":null,"abstract":"<p><strong>Introduction: </strong>Precise morphometric data of the axillary vein (AV) network are essential for surgical and endovascular safety. This study aims to characterize main-trunk morphometry, formation patterns (Types A/B), tributary variations, and the lateral venous channel (LVC), providing an anatomical framework potentially relevant to surgical navigation and vascular access.</p><p><strong>Materials and methods: </strong>Forty formalin-fixed upper extremities from adult whole-body donors were dissected. Two independent investigators measured external venous diameters at standardized landmarks and the AV to coracoid apex distance; terminal drainage patterns were recorded during dissection. The LVC was operationally defined as a distinct longitudinal venous channel coursing along the lateral axillary wall, separate from the main AV and from the principal course of its distal communicating vein, while forming an additional distal-to-proximal venous connection within the axillary venous system.</p><p><strong>Results: </strong>Mean proximal AV diameter was 10.42 ± 2.06 mm; distance from the coracoid apex to the AV was 44.01 ± 13.08 mm. Male donors showed significantly larger proximal AV (p = 0.016) and subscapular vein (p = 0.033) diameters. Brachial vein termination comprised Type A (independent, 75.0%) and Type B (common trunk, 25.0%). An LVC was identified in 62.5% of specimens, most frequently showing distal communication with the lateral brachial vein and proximal termination in the AV. Cephalic vein absence was 10.0%.</p><p><strong>Conclusions: </strong>The axillary venous network displays marked variability. The LVC represents a recurrent lateral axillary venous configuration with variable distal communications; in the present series, all identified channels joined the AV proximally. These findings provide a detailed anatomical framework that may assist procedural planning and recognition of venous variations during axillary interventions.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in the formation of the superficial palmar arch and its relationship to Kaplan's cardinal line: a study in a central Indian cadaveric sample.","authors":"Vaibhav Saini, Shahin M Kazi, Mayanka Shrivastava, Dhiren Kumar Panda","doi":"10.1007/s00276-026-04032-4","DOIUrl":"10.1007/s00276-026-04032-4","url":null,"abstract":"<p><strong>Purpose: </strong>The superficial palmar arch (SPA) is the main arterial supply of the palm and varies in the way it is completed. Knowledge of these patterns, and of the position of the arch relative to surface landmarks, is needed for safe carpal tunnel release and for procedures that sacrifice the radial or ulnar artery. We documented the SPA in a central Indian cadaveric sample and its relationship to Kaplan's cardinal line.</p><p><strong>Methods: </strong>Fifty formalin-fixed adult upper limbs were dissected. During the study period the department held 20 registered whole-body cadavers and, in addition, a number of upper limbs that had been received already separated from the trunk without an accompanying donor record; the number of limbs contributed by each source, and hence the number of individual donors represented among the 50 limbs, could not be established (see Methods and Limitations). The arch was classified by the Coleman and Anson method into complete (Group I, types A-E) and incomplete (Group II, types F-I) forms, and its position relative to Kaplan's cardinal line was recorded in each limb.</p><p><strong>Results: </strong>A complete arch was present in 41 limbs (82%; 95% CI 69.2-90.2%) and an incomplete arch in nine (18%). Type B (ulnar only) was the most common complete form (42%), followed by type A (34%) and type E (6%); types C and D were absent. Among incomplete arches, type F predominated (10%), with types G (6%) and H (2%) less frequent and type I absent. In every limb the arch lay distal to Kaplan's cardinal line.</p><p><strong>Conclusion: </strong>The frequency of the complete arch is comparable to pooled international data. The constant position of the arch distal to Kaplan's cardinal line supports the use of this landmark as a distal reference for palmar incisions during carpal tunnel surgery, although, because only the categorical position of the arch was recorded, this finding does not by itself define a quantitative safety margin.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical variation in the cervical branch of the facial nerve: a systematic review.","authors":"Joseph Pathiparampil Mano, Shubham Dave, Mohammed Faraaz Saiyed, Yangmyung Ma, Kallirroi Tzafetta, Sami Al-Ani","doi":"10.1007/s00276-026-03969-w","DOIUrl":"10.1007/s00276-026-03969-w","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of literature on the anatomical variations of the cervical branch of the facial nerve (CBFN). Poor awareness of its anatomy and variations risks intraoperative damage, misdiagnosis of facial nerve injury and undesirable functional and aesthetic outcomes for patients.</p><p><strong>Purpose: </strong>To review anatomical studies on the CBFN and synthesise data on its course, innervations and common variations.</p><p><strong>Methods: </strong>A PRISMA-compliant systematic review of anatomical studies of the cervical branch of the facial nerve was conducted. PubMed, Embase, Scopus, Cochrane Library, Web of Science, and Google Scholar were searched up to July 2025. Papers were quality appraised, and data relevant to the anatomy of the CBFN were extracted.</p><p><strong>Results: </strong>Thirty-five papers with a collated sample size of 867 hemi-necks were identified: 25 with anatomical dissections and 10 case reports. The mean number of CBFN branches was 1.34 (sensitivity range 1.31-1.36). Communication with the marginal mandibular nerve, transverse cervical nerve and great auricular nerve was variable, with prevalences ranging from 22-97%. Distances between the nerve and anatomical landmarks were heterogeneous. Many individual cases of cervical branch variation in course and relationship to nearby vasculature were identified.</p><p><strong>Conclusion: </strong>The cervical branch of the facial nerve displays wide variability in its course. Pre-operative mapping, careful dissection and intra-operative nerve stimulation to aid accurate identification are recommended to prevent iatrogenic damage.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A short large-calibre intrapelvic arterial bridge between the superior and inferior gluteal arteries: an in vivo CT angiographic observation.","authors":"Mugurel Constantin Rusu, Sorin Hostiuc, Adelina Maria Jianu","doi":"10.1007/s00276-026-04029-z","DOIUrl":"10.1007/s00276-026-04029-z","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a short, large-calibre intrapelvic arterial bridge between independently established superior and inferior gluteal arteries (SGA and IGA) and to distinguish it from a common gluteal trunk.</p><p><strong>Methods: </strong>A pelvic computed tomography angiography (CTA) examination from a 40-year-old man was retrospectively analysed from an anonymised archive using multiplanar reformations, maximum-intensity projections, and three-dimensional vascular reconstructions. Linear and calibre measurements were obtained with workstation callipers and verified by independent review.</p><p><strong>Results: </strong>On the right, the internal iliac artery divided after 34 mm into anterior and posterior trunks. The anterior trunk gave the obturator and internal pudendal arteries and continued as the IGA (2.6 mm); the posterior trunk gave sacral arteries and continued as the SGA (4.0 mm). The SGA and IGA were connected 44.2 mm distal to the internal iliac bifurcation by a 1.8-mm-long, 3.5-mm-calibre intrapelvic bridge. The SGA exited suprapiriformly and the IGA infrapiriformly. No corresponding bridge was present on the left.</p><p><strong>Conclusion: </strong>The configuration differs from an Adachi Type II common SGA-IGA trunk because the two gluteal arteries are already anatomically separate before the communicating segment. Strict assignment to an Adachi type is not possible from this CTA alone because the umbilical continuation of the hypogastric axis is not demonstrated. Previous cadaveric studies documented SGA-IGA communications, whereas the present observation provides individual in vivo CTA topography and morphometry of a very short, large-calibre bridge.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between the vagus nerve and the common carotid artery in thyroid surgery: an ultrasonographic study.","authors":"Simge Eşme, Duygu Kalaycı, Berin Tuğtağ Demir, Burak Bilecenoğlu, Kaan Orhan","doi":"10.1007/s00276-026-04025-3","DOIUrl":"10.1007/s00276-026-04025-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the positional relationship of the cervical vagus nerve with the common carotid artery (CCA) and internal jugular vein (IJV) using high-resolution ultrasonography and to identify anatomical variations relevant to vagus nerve localization during intraoperative neuromonitoring (IONM) in thyroid surgery.</p><p><strong>Methods: </strong>This prospective observational study included 97 individuals aged 20-30 years, providing 194 cervical sides for analysis. The vagus nerve was evaluated bilaterally using high-resolution ultrasonography and classified into six positional patterns according to its relationship with the CCA and IJV. Positional distributions were compared according to side and sex.</p><p><strong>Results: </strong>Position 1 was the most frequent configuration (n = 128, 66.0%), followed by Position 2 (n = 59, 30.4%). Positions 3 and 4 were observed in 5 (2.6%) and 2 (1.0%) sides, respectively. Positions 5 and 6 were not observed in any case. Thus, the vagus nerve was predominantly located between the great vessels, while superficial and medial-superficial variants were uncommon. No statistically significant association was found between vagus nerve position and side or sex (all p > 0.05).</p><p><strong>Conclusion: </strong>The cervical vagus nerve exhibits positional variation within the carotid sheath, although it is predominantly located between the CCA and IJV. High-resolution ultrasonography allows identification of these anatomical variations and may facilitate preoperative localization of the vagus nerve, potentially supporting safer IONM and reducing the risk of iatrogenic neural injury during thyroid surgery.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"48 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}