The investing layer of the deep cervical fascia does not exist between the sternocleidomastoid and trapezius muscles.

Department of Anatomy and Structural Biology, University of Otago, Dunedin, New Zealand. zhang.ming@stonebow.otago.ac.nz

OBJECTIVE: We sought to describe the 3-dimensional organization of connective tissues in the suboccipital region. Study Design and Setting: We conducted a sectional anatomic investigation with the use of E12 sheet plastination. SUBJECTS: Six human adult cadavers (2 male and 4 female; age range, 54 to 86 years) were used in this study. Five of them were sectioned as 2.5-mm-thick coronal (1 cadaver), transverse (2 cadavers), or sagittal (2 cadavers) sections. RESULTS: No aggregation of fibrous connective tissue was seen between the sternocleidomastoid and trapezius muscles. The intervening space was fully occupied by fatty tissue that was indistinguishable from the subcutaneous tissue. CONCLUSIONS: The investing layer of the deep cervical fascia is incomplete so that the carotid sheath is directly exposed to the subcutaneous tissue via a gap between the sternocleidomastoid and trapezius muscle. SIGNIFICANCE: This anatomic feature should be considered when designing a minimally invasive endoscopic approach to the carotid sheath and the surrounding deep cervical structures.

PMID: 12447241 [PubMed - indexed for MEDLINE]