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Anatomical landmarks for the identification of greater occipital nerve for micro-surgical decompression/excision

C. Bozer, D. Donmez, M.A. Karahan, A.Z. Yilmazer, M. Parlak

Abstract

If pharmacological and local nerve blocking treatment fail in severe cases of occipital neuralgia surgical intervention of greater occipital nerve (GON) should be considered. In the literature two types of interventions were suggested: surgical decompression of the GON from the entrapment site, and neurotomy of the nerve trunk. In some cases, due to anatomical variations in the division of the GON trunk, typical neurotomy above the line of the trapezius muscle aponeurosis (TMA) may not result in full recovery.The anatomical landmarks for the GON have been studied comprehensively in the literature. The aim of this study is to find the emergence point of GON by making the measurements over the skin. The dissections and measurements were made on 7 formalin fixed cadaver heads. After measuring the distance between protuberentia occipitalis externa and processus mastoideus, a small incision was made to find the point in which GON pierces the m. trapezius. The measurements were made after dissecting the GON.The distance between protuberentia occipitalis externa and processus mastoideus was 10,16 cm and 10,1 cm for right and left sides, respectively. The distance between the midline and emergence point of the GON was 1,77 cm and 1,96 cm; the vertical distance from the line between protuberentia occipitalis externa and processus mastoideus to the emergence point of the GON was 2,43 cm and 2,34 cm for right and left sides, respectively.From our data, for micro-surgical decompression and/or excision we recommend exploring the emergence point of GON according to the above given mean distances.




DOI: http://dx.doi.org/10.14748/ssm.v48i0.2372
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About The Authors

C. Bozer

D. Donmez

M.A. Karahan

A.Z. Yilmazer

M. Parlak

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