Anterior Greater Auricular Point: Novel Anatomic Landmark to Facilitate Harvesting of the Greater Auricular Nerve

Authors

Ali Tayebi Meybodi, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Sirin Gandhi, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Mark C. Preul, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: neuropub.preul@barrowneuro.org.Follow

Document Type

Article

Abstract

BACKGROUND: The greater auricular nerve (GAN) may be used as a nerve graft during neurosurgical procedures to repair damaged nerves. There is extensive literature on localization of the GAN at the posterior triangle of the neck, but objective information on localization of the GAN at the anterior triangle of the neck close to cranial neurosurgical fields is lacking. The aim of this study was to introduce simple and reliable landmarks to localize the GAN at the anterior triangle of the neck to facilitate its harvest during neurosurgical procedures. METHODS: The GAN was exposed bilaterally in 11 cadaveric specimens at the point of crossing the anterior border of the sternocleidomastoid muscle (anterior greater auricular point [AGA]). Distances from the AGA point to the angle of the mandible and the tip of the mastoid process were measured. Additionally, the location of the crossing point between the GAN and an imaginary line passing through the mastoid tip and the angle of the mandible (M-A line) was found relative to these bony landmarks. RESULTS: Mean (±SD) distances from the AGA point to the mastoid tip and the angle of the mandible were 29.1 ± 3.4 mm and 27.5 ± 4.5 mm, respectively. The GAN was always found to cross the M-A line in its middle third (mean 48.2% ± 6.9% from the mastoid tip). CONCLUSIONS: The AGA point and the M-A line are reliable landmarks for locating the GAN at the anterior triangle of the neck and for helping neurosurgeons expose and harvest the GAN efficiently.

Medical Subject Headings

Accessory Nerve (anatomy & histology, surgery); Anatomic Landmarks; Cadaver; Clavicle (surgery); Dissection (methods); Humans; Mandible (anatomy & histology, innervation); Mastoid (innervation); Neck (innervation); Neck Muscles (innervation, surgery)

Publication Date

7-19-2018

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

119

First Page

e64

Last Page

e70

PubMed ID

30017768

Digital Object Identifier (DOI)

10.1016/j.wneu.2018.07.001

Recommended Citation

Tayebi Meybodi, Ali; Gandhi, Sirin; Lawton, Michael T.; and Preul, Mark C., "Anterior Greater Auricular Point: Novel Anatomic Landmark to Facilitate Harvesting of the Greater Auricular Nerve" (2018). Neurosurgery. 1300.
https://scholar.barrowneuro.org/neurosurgery/1300