Surgical Anatomy of the Neck

Abstract

The neck affords one of the most surgically complex anatomy in the human body, as it contains vital or otherwise functionally relevant structures. Among these are the upper aero-digestive tract, the great neck vessels and cranial nerves VII, X, XI and XII along with the cervical and brachial plexus, and the phrenic nerve. Accurate knowledge of this intricate anatomy is essential to avoid complications, particularly long-term functional impairment, mainly following injury of nervous structures. The neck harbors more than 300 lymph nodes, whose physiopathological role in conditions such as infections and cancer represent an important surgically therapeutic target. In this chapter, we review the cervical fasciae and lymphatic drainage patterns of the neck as basis for its international known lymph node level system I–VI. Furthermore, the nodal levels are delineated in-depth while emphasizing the most important anatomical landmarks.

All figures by Hergen Friedrich and Gianni Pauciello. The copyright belongs to H. Friedrich and G. Pauciello, Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.