The carotid sheath: Anatomy and clinical considerations
Objectives: The distinctive bilateral carotid sheaths (CS) reside in the neck region and form part of the deep cervical fasciae. Aspects of the CS anatomy are controversial, most notably its specific attachment sites and fascial makeup, which are key determinants for the spread of tumours and infect...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | World Neurosurgery: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139723000078 |
| _version_ | 1797850219833982976 |
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| author | Jacob D. Bond Feng Zheng Qin Wang Ming Zhang |
| author_facet | Jacob D. Bond Feng Zheng Qin Wang Ming Zhang |
| author_sort | Jacob D. Bond |
| collection | DOAJ |
| description | Objectives: The distinctive bilateral carotid sheaths (CS) reside in the neck region and form part of the deep cervical fasciae. Aspects of the CS anatomy are controversial, most notably its specific attachment sites and fascial makeup, which are key determinants for the spread of tumours and infections and surgical planning. This review aimed to organise the pertinent aspects relating to CS anatomy and pathology, explore their clinical relevance and highlight areas of disagreement in the literature. Methods: A narrative review identified key papers relating to CS anatomy, histology, embryology, pathology and clinical and surgical significance using PubMed and Google Scholar. This was supported by a systematic review focused on the fascia forming the CS which was conducted using PubMed, Web of Science and Core Collection which yielded 22 papers. Results: and Discussion: The CS surrounds the internal carotid artery, internal jugular vein, cranial nerves IX - XII, lymph nodes and nervous plexuses as they course from the jugular foramen superiorly down along into the mediastinum inferiorly. There are contradicting descriptions regarding the CS attachments at the extracranial skull base and within the mediastinum. Author descriptions of the CS fasciae are complex, varied and incongruent. Pathologies affecting the CS include malignancies of the nerves, vascular lesions and utilisation of the CS space as a corridor for the spread of deep neck infections. Conclusion: This paper collates and presents pertinent anatomical and clinical aspects regarding the CS. A proper knowledge of the CS anatomy and structural relationships will optimise surgical approaches and orientation when operating within the region. |
| first_indexed | 2024-04-09T18:57:57Z |
| format | Article |
| id | doaj.art-350be6dee35e48b6a1c128eafb18af2b |
| institution | Directory Open Access Journal |
| issn | 2590-1397 |
| language | English |
| last_indexed | 2024-04-09T18:57:57Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj.art-350be6dee35e48b6a1c128eafb18af2b2023-04-09T05:49:50ZengElsevierWorld Neurosurgery: X2590-13972023-04-0118100158The carotid sheath: Anatomy and clinical considerationsJacob D. Bond0Feng Zheng1Qin Wang2Ming Zhang3Department of Anatomy, University of Otago, Dunedin, New Zealand; Dunedin School of Medicine, University of Otago, Dunedin, New ZealandDepartment of Anatomy, University of Otago, Dunedin, New ZealandDepartment of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, ChinaDepartment of Anatomy, University of Otago, Dunedin, New Zealand; Department of Anatomy, Anhui Medical University, Hefei, 230022, China; Corresponding author. Department of Anatomy, University of Otago P.O. Box 913, 270 Great King Street, Dunedin, 9054, New Zealand.Objectives: The distinctive bilateral carotid sheaths (CS) reside in the neck region and form part of the deep cervical fasciae. Aspects of the CS anatomy are controversial, most notably its specific attachment sites and fascial makeup, which are key determinants for the spread of tumours and infections and surgical planning. This review aimed to organise the pertinent aspects relating to CS anatomy and pathology, explore their clinical relevance and highlight areas of disagreement in the literature. Methods: A narrative review identified key papers relating to CS anatomy, histology, embryology, pathology and clinical and surgical significance using PubMed and Google Scholar. This was supported by a systematic review focused on the fascia forming the CS which was conducted using PubMed, Web of Science and Core Collection which yielded 22 papers. Results: and Discussion: The CS surrounds the internal carotid artery, internal jugular vein, cranial nerves IX - XII, lymph nodes and nervous plexuses as they course from the jugular foramen superiorly down along into the mediastinum inferiorly. There are contradicting descriptions regarding the CS attachments at the extracranial skull base and within the mediastinum. Author descriptions of the CS fasciae are complex, varied and incongruent. Pathologies affecting the CS include malignancies of the nerves, vascular lesions and utilisation of the CS space as a corridor for the spread of deep neck infections. Conclusion: This paper collates and presents pertinent anatomical and clinical aspects regarding the CS. A proper knowledge of the CS anatomy and structural relationships will optimise surgical approaches and orientation when operating within the region.http://www.sciencedirect.com/science/article/pii/S2590139723000078Carotid sheathDeep cervical fasciaInternal carotid arteryInternal jugular veinLower cranial nervesPathology |
| spellingShingle | Jacob D. Bond Feng Zheng Qin Wang Ming Zhang The carotid sheath: Anatomy and clinical considerations World Neurosurgery: X Carotid sheath Deep cervical fascia Internal carotid artery Internal jugular vein Lower cranial nerves Pathology |
| title | The carotid sheath: Anatomy and clinical considerations |
| title_full | The carotid sheath: Anatomy and clinical considerations |
| title_fullStr | The carotid sheath: Anatomy and clinical considerations |
| title_full_unstemmed | The carotid sheath: Anatomy and clinical considerations |
| title_short | The carotid sheath: Anatomy and clinical considerations |
| title_sort | carotid sheath anatomy and clinical considerations |
| topic | Carotid sheath Deep cervical fascia Internal carotid artery Internal jugular vein Lower cranial nerves Pathology |
| url | http://www.sciencedirect.com/science/article/pii/S2590139723000078 |
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