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Surgical and Radiologic Anatomy

, Volume 33, Issue 1, pp 53–57 | Cite as

Three nearly forgotten anatomical triangles of the neck: triangles of Beclard, Lesser and Pirogoff and their potential applications in surgical dissection of the neck

  • R. Shane Tubbs
  • Mark Rasmussen
  • Marios Loukas
  • Mohammadali M. Shoja
  • Aaron A. Cohen-Gadol
Original Article

Abstract

The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well known; however, some have been nearly forgotten. The purposes of this study were to review prior literature on the forgotten triangles of the neck, to measure and document the occurrence of these triangles and the structures found within them, and to discuss their surgical significance and relationships to the standard triangles of the neck. This study was carried out on 17 (34 sides) formaldehyde-fixed adult human cadavers (5 males and 12 females), the mean age being 78 years. All triangles were found within the submandibular triangle of the anterior cervical triangle. Beclard’s triangle was present on 28 sides and absent on 6 sides because the posterior belly of the digastric muscle did not touch the hyoid bone and because the posterior belly of the digastric muscle was directly over the greater cornu of the hyoid bone. Lesser’s triangle was present on 30 sides and absent on 4 sides because the hypoglossal nerve remained inferior to the digastric muscle. Pirogoff’s triangle was also present on 30 sides and absent on 4 sides, again because the hypoglossal nerve remained inferior to the digastric muscle. No statistically significant differences were found between the measurements of each leg of any of the three triangles and gender, or between the measurement of each leg of any of the three triangles and right versus left sides. Beclard’s triangle, when present, was found to contain both the hypoglossal nerve and the lingual artery. Pirogoff’s triangle always contained the lingual artery, and Lesser’s triangle contained no major structures, but the lingual artery was deep to its floor. Knowledge of these triangles, their contents, and relationships to other structures of the neck could be important for cranio-facial, oral, general, and neurosurgeons who operate within the neck.

Keywords

Neck Anatomy Surgery Landmarks 

References

  1. 1.
    Bademci G, Yaşargil MG (2006) Microsurgical anatomy of the hypoglossal nerve. J Clin Neurosci 13:841–847CrossRefPubMedGoogle Scholar
  2. 2.
    Béclard PA (1824) Extirpation de la parotide, pratiquée l’hôpital de la Pitié. Arch Gen Med 4:60–66Google Scholar
  3. 3.
    Béclard PA (1830) Elements of general anatomy. MacLachlan and Stewart, EdinburghGoogle Scholar
  4. 4.
    Burke RH, Masch GL (1986) Lingual artery hemorrhage. Oral Surg Oral Med Oral Path 62:258–261CrossRefPubMedGoogle Scholar
  5. 5.
    Campbell WF (1922) A text-book of surgical anatomy, 3rd edn. W. B. Saunders, BrooklynGoogle Scholar
  6. 6.
    Deaver JB (1926) Surgical anatomy of the human body. Blakiston, PhiladelphiaGoogle Scholar
  7. 7.
    (2003) Dorland’s illustrated medical dictionary, 30th edn. Saunders, PhiladelphiaGoogle Scholar
  8. 8.
    Forbis P, Bartolucci SL (1998) Stedman’s medical eponyms. Williams and Wilkins, BaltimoreGoogle Scholar
  9. 9.
    Healey JE, Hodge J (1990) Surgical anatomy, 2nd edn. B.C. Decker Inc., TorontoGoogle Scholar
  10. 10.
    Heisler JC (1912) Practical anatomy. J. B. Lippincott, PhiladelphiaGoogle Scholar
  11. 11.
    Homze EJ, Harn SD, Bavitz BJ (1997) Extraoral ligation of the lingual artery: an anatomic study. Oral Surg Oral Med Oral Path Oral Rad Endo 83:321–324CrossRefGoogle Scholar
  12. 12.
    Jamieson GG (2006) The anatomy of general surgical operations, 2nd edn. Elsevier, EdinburghGoogle Scholar
  13. 13.
    Orly R (1995) Dictionary of anatomical eponyms. Gustav Fischer Verlag, StuttgartGoogle Scholar
  14. 14.
    Pirogoff NI (1852–1859) Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductis illustrate. St. PetersburgGoogle Scholar
  15. 15.
    Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A, Some P, Wolf GT (2002) Neck dissection classification update. Arch Otolaryngol Head Neck Surg 128:751–758PubMedGoogle Scholar
  16. 16.
    Skandalakis JE (2004) Skandalakis’ surgical anatomy: the embryologic and anatomic basis of modern surgery. Paschalidis Medical Publications, AthensGoogle Scholar
  17. 17.
    Skandalakis JE, Gray SW, Rowe JS (1979) Surgical anatomy of the submandibular triangle. Am Surg 45:590–596PubMedGoogle Scholar
  18. 18.
    van Es RJJ, Thuau H (2000) Pirogoff’s triangle revisited: an alternative site for microvascular anastomosis to the lingual artery. Int J Oral Maxillofacial Surg 29:207–209CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • R. Shane Tubbs
    • 1
  • Mark Rasmussen
    • 1
  • Marios Loukas
    • 2
  • Mohammadali M. Shoja
    • 3
  • Aaron A. Cohen-Gadol
    • 3
  1. 1.Department of Pediatric NeurosurgeryChildren’s HospitalBirminghamUSA
  2. 2.Department of Anatomical SciencesSt. George’s UniversityGrenadaWest Indies
  3. 3.Indianapolis Neurosurgical Group, Department of Neurosurgery, Clarian Neuroscience InstituteIndiana UniversityIndianapolisUSA

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