Applied anatomy of anastomosis between the cervical loopor sternocleidomastoid muscular branches of the accessory nerve and the phrenic nerve for treatment of dyspnea after paraplegia

Objective: To seek donor nerve to anastomose with the phrenic nerve for the reconstruction of autonomous breathing after paraplegia.Met hods: The ce rvical loops, sternocleido-mastoid muscular branches of the accessory nerves a nd the phrenic nerves on fifteen adult cadavers were observed and measured.Results: The length of the descending branch hypoglossal nerve and cervical nerve were 4 0.0±8.2 mm and 32.0±6.8 mm respectively. Their width, thickness and amounts of nervous bundle at the level of the laryngeal prominence were 1.9±0.5 mm and 0. 8 ±0.1 mm, 1.6±0.5 mm and 0.6±0.1 mm, 3 and 2 bundle respectively. The sternocl eido-mastoid muscular branch of the accessory nerve was 15.9±4.2 mm long. And its width and thickness at the entrance into muscle were 2.3±0.7 mm and 0.9 ±0. 2 mm respectively.The width, thickness and amounts of nervous bundle of the phre n ic nerve at its convergence point were 2.1±0.5 mm, 1.2±0.4 mm and 4.0±0.5 bun dle respectively. 80%(n=24) of the sternocledo-mastoid muscular branches of the accessory nerve had a interval (averaged 20.2±6.3 mm) with the phrenic nerves, 13% of them ( n =4) were close to it, and 7%( n =2) of them run parallel wi th it.Conclusion: These results suggest that the upper and lower roots of the cervical loop or the sternocleido-mastoid muscular branches of the accessory nerve are s uitable donors for end-to-end for end-to-side anastomoses of the phrenic ner ve at its origin or converge point.