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How Do the Cervical Plexus and the Spinal Accessory Nerve Contribute to the Innervation of the Trapezius Muscle?
As Seen From Within Using Sihler's Stain
Antonius C. Kierner, MD;
Irmgard Zelenka, MD;
Martin Burian, MD
Arch Otolaryngol Head Neck Surg. 2001;127:1230-1232.
Objective To determine how the spinal accessory nerve and the trapezius branches
of the cervical plexus contribute to the innervation of each of the 3 parts
of the trapezius muscle. Special emphasis was placed on the nerve supply of
the clinically most important descending part of the muscle.
Design Anatomical analysis of the distribution of the cervical plexus and spinal
accessory nerve branches in the human trapezius muscle.
Materials Twenty-two trapezius muscles from 11 perfusion-fixed human cadavers
ranging in age from 66 to 92 years (mean, 81.7 years).
Interventions The specimens were dissected free and macerated, decalcified, and stained
according to Sihler's technique for about 6 weeks. The translucent, stained
muscles were then backlit, and the findings were documented photographically
and by schematic drawings.
Results In all 22 muscles, the innervation of each of the 3 parts of the trapezius
muscle was seen. In all muscles investigated, the nerve supply to the descending
part of the muscle consisted of a single fine branch of the spinal accessory
nerve, whereas the transverse and ascending parts were innervated by both
the spinal accessory nerve and the trapezius branches of the cervical plexus.
Conclusion Our results, especially those involving the descending part of the trapezius
muscle, may help to minimize the rate of unexpected trapezius muscle paresis
after surgery of the neck.
From the Ear, Nose, and Throat Department, University Hospital Vienna
(Drs Kierner and Burian), and the Institute of Anatomy 2, University of Vienna
(Dr Zelenka), Vienna, Austria. Dr Kierner is now with the Ear, Nose, and Throat
Department, University of Frankfurt, Frankfurt a.M., Germany.
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Arch Otolaryngol Head Neck Surg. 2001;127(10):1289-1291.
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