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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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