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Topographic anatomy of the great auricular point: landmarks for its localization and classification

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Abstract

Purpose

The great auricular point (GAP) marks the exit of the great auricular nerve at the posterior border of the sternocleidomastoid muscle (SCM). It is a key landmark for the identification of the spinal accessory nerve, and its intraoperative localization is vital to avoid neurological sequelae. This study delineates the topography and surface anatomy landmarks that used to localize the GAP.

Methods

Thirty cadaveric heminecks were dissected on a layer-by-layer approach. The topography of the GAP was examined relative to the insertion point of the SCM at the clavicle, tip of the mastoid process, and angle of the mandible. The GAP and its relation to the SCM were determined as a ratio of the total length of the SCM.

Results

The GAP was demonstrated to be in a predictable location. The mean length of the SCM was 131.4 ± 22 mm, and the mean distance between the GAP and the mastoid process was found to be 60.4 ± 13.76 mm. The ratio of the GAP location to the total SCM length ranged between 0.33–0.57. The mean distance between the angle of the mandible and the GAP was determined to be 57 ± 22.2 mm. Based on the midpoint of the SCM, the GAP was above it in 66.7 % of subjects and classified to Type A, and below it in 33.3 % of subjects appointed to Type B.

Conclusions

The anatomical landmarks utilized in this study are helpful in predicting the location of the GAP relative to the midpoint of the SCM and can reduce neural injuries within the posterior triangle of the neck.

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Authors and Affiliations

  1. Anatomical Sciences, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, 4229, Australia

    Athanasios Raikos, Thomas English, Omar Khalid Yousif, Mandeep Sandhu & Allan Stirling

Authors
  1. Athanasios Raikos
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  2. Thomas English
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  3. Omar Khalid Yousif
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  4. Mandeep Sandhu
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  5. Allan Stirling
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Correspondence to Athanasios Raikos.

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The authors declare that they have no competing interests. All authors have read and accepted the final draft of the manuscript.

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Raikos, A., English, T., Yousif, O.K. et al. Topographic anatomy of the great auricular point: landmarks for its localization and classification. Surg Radiol Anat 39, 535–540 (2017). https://doi.org/10.1007/s00276-016-1758-y

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  • DOI: https://doi.org/10.1007/s00276-016-1758-y

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