Bilateral Supernumerary Sternocleidomastoid Heads with Critical Narrowing of the Minor and Major Supraclavicular Fossae: Clinical and Surgical Implications (original) (raw)
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Bilateral supernumerary sternocleidomastoid heads with clinical and surgical implications
The sternocleidomastoideus muscle is one of the most complex muscles of the body. A wide mention of supernumerary and accessory musculature has been made in the literatures. In majority of cases, accessory muscles are asymptomatic and usually incidental findings at surgery or imaging. The objective of this study was to determine the prevalence of additional head of sternocleidomastoideus muscle, describe an anatomical variation of bilateral sternocleidomastoideus anatomy and review the clinical and surgical significance. A total of 16 cadavers of both sexes (15 men and 1 women) with different age group were used for the study. Head and neck region (32 sides) of the cadavers were carefully dissected as per the standard dissection procedure in the Morphology Laboratory at the University of Pamplona. The morphological variations in the number of heads (three and four) of origin of sternocleidomastoideus muscle were observed in 2 out de 16 neck (12,5%). It was found in two male subjects in right and left neck, bilaterally. The remaining 14 neck (87,5%) showed the normal origin, insertion, course of the sternocleidomastoideus and the course and branching patterns of the spinal accessory nerve and arterial patterns was normal having classic branching. The Knowledge of the presence of additional heads of Sternocleidomastoideus muscle is the interest why may cause functional deficits since its covers the important neurovascular structures of the neck; it might cause difficulties in the surgery in that region. It may also interfere in invasive techniques.
BILATERAL FOUR AND SIX HEADS OF THE STERNOCLEIDOMASTOID MUSCLE. A CADAVERIC FINDING
International Journal of Pharmaceutical Research, 2019
Background: The sternocleidomastoid muscle present a wide patterns of variations which including supernumerary muscular heads. Aim: The aim of the present study is report bilateral four and six heads of the sternocleidomastoid muscle. Materials and Methods: The anatomical variation was found during routine dissection performed in the laboratory of Morphology of the University of Pamplona. Findings: On the right side, two sternal head were a continuous sheet with a small gap of 1 mm; the third head originating from sternoclavicular joint until the clavicular head. The fourth, clavicular head that arose from the medial and middle third of the clavicle. On the left side of the neck, two sternal heads were lying side by side. Of the four clavicular heads, two were superficial and another two lying in a deep plane. Conclusions: Knowledge of these anatomical variations is important for any therapeutics and diagnostic intervention in the region neck.
Anatomical description and clinical significance of unilateral triheaded sternocleidomastoid muscle
International Journal of Research in Medical Sciences, 2014
Objective of this report is to observe and report unusual pattern of origin of sternal and clavicular heads of Sternocleidomastoid (SCM). An embryological insight into the possible causes for present anomaly is elucidated. The neck region of an adult male cadaver during gross anatomy teaching program. An abnormal Sternocleidomastoid (SCM) was observed while dissecting the neck region of an adult. Additional clavicular head of SCM muscle were found on the right side. The accessory clavicular head coursed deep to the sternal head whereas the some fibres of main clavicular head joined the accessory belly and together they fused with the main sternal head of SCM. There was another slip arising from sternal head and merge with deep cervical fascia near base of mandible. The topographical anatomy of SCM is extremely important, particularly because it serves as a useful surgical landmark and its relation to crucial neuro-vascular structures of the neck. The usage of SCM in reconstruction operations for covering defects is discussed. A detailed knowledge of the anatomy of SCM proves vital for radiological studies of the neck.
Int. J. …, 2010
FAZLIOGULLARI, Z.; CICEKCIBASI, A, E.; UNVER DOGAN, N.; YILMAZ, M. T.; BUYUKMUMCU, M. & ZIYLAN, T. The levator claviculae muscle and unilateral third head of the sternocleidomastoıd muscle: case report. Int. J. Morphol., 28(3):929-932, 2010.
A RARE CASE OF BILATERAL STERNOCLEIDOMASTOID MUSCLE VARIATION
International Journal of Pharmaceutical Research, 2019
Background: The abnormal origin, presence of additional head and layered arrangement of fibers are the reported variations of sternocleidomastoid muscle. Aims: The aim of the present study is report a rare bilateral anatomical variation of the sternocleidomastoid muscle. Materials and Methods: The anatomical variations were found during a routine dissection performed in the laboratory of Morphology of the University of Pamplona. Findings: In accordance with their origin, insertion, in the right side, in the superficial layer were dissected muscular bundle considered as sternocleidooccipital and sternomastoid muscle. In the deep layer, muscular bundles considered as cleidomastoid and sternocleidomastoid muscle was observed. In the left side, additional head originated from the investing deep layer of cervical fascia in the roof of the lesser supraclavicular fossa, traversed obliquely downward, backward, fused with clavicular head. Conclusion: The presence of this anatomical variation it might cause difficulty in assessing the vital neurovascular structures of the neck.
International Journal of Morphology, 2023
This study aimed to classify and investigate anatomical variations of the sternocleidomastoid (SCM) muscle, which is commonly used as an anatomical landmark to indicate the correct position for central venous catheterization, in a Thai population. Thirtyfive embalmed cadavers from the Northeast Thailand (19 females and 16 males) were systemically dissected to reveal the SCM muscles in both sides for gross human anatomy teaching. Variations in the SCM origin and insertion were observed and recorded. The prevalence of anatomical variations was approximately 11.4 % (4 of 35 cadavers) and was not different by sex. Such variations were classified into 5 types based on origin, insertion, and presence of additional heads, as follows: type I (n=31; 88.6 %), type II (n=1; 2.85 %), type III (n=1; 2.85 %), type IV (n=1; 2.85 %), and type V (n=1; 2.85 %). Clinical considerations and prevalence of variant SCM muscle have also been discussed. Since the incidence of this anatomical variations was more than 10 %, the cervical surgeons should seriously consider this issue before insertion of a central venous catheter to avoid complications.
A Rare Case of Unilateral Third Head of Sternocleidomastoid Muscle
International Journal of Morphology, 2008
A rare case of unilateral third head of sternocleidomastoid muscle was noted during routine dissections for undergraduate medical students. The additional third head originated from the middle third of the clavicle and joined the normal two heads (sternal and clavicular) of the muscle in the middle of the neck. The insertion and nerve supply of the muscle was normal. This case may be important for head and neck surgeons and for plastic surgeons doing muscle graft surgeries.
An unusual sternalis with variation of the contralateral sternocleidomastoid muscle: A Case Report
Purpose To report a previously undocumented variant of sternalis. Methods An unusual muscle was observed during routine dissection. Results The sternalis muscle located in the right thoracic region originated from the superior portion of the rectus abdominis sheath and 5-6th costal cartilages, crossed the midline and attached at the sternum. The muscle fibers then ascended with the left sternocleidomastoid muscle as an additional fasciculus, of which the superior ends were finally terminated at the left mastoid process. The sternalis muscle of the thoracic region was innervated by the anterior cutaneous branches of right intercostal nerve, while the additional fasciculus ascended with the left sternocleidomastoid muscle was innervated by the branches of left accessory nerve. Conclusions This study presents a unilateral sternalis muscle with the contralateral sternocleidomastoid variation. It will enhance the exhaustive classification of sternalis, and provide significant information...
Bilateral sternocleidomastoid variant with six distinct insertions along the superior nuchal line
Anatomy & Cell Biology, 2018
Anatomical variations of the sternocleidomastoid muscle (SCM) have been observed to occupy multiple origins and insertion points and have supernumerary heads, sometimes varying in thickness. During routine dissection, a SCM was observed to have six distinct insertions that interface with the course of the superior nuchal line, ending at the midline, bilaterally. This variation was also seen to receive innervation from the accessory nerve as well as the great auricular nerve. To our knowledge, this variant of supernumerary insertions and nerve innervations has not yet been reported. These variants may pose as problematic during surgical approaches to the upper neck and occiput, and should thus be appreciated by the clinician. Herein we discuss the case report, possible embryological origins, and the clinical significance of the observed variant SCM.