Get access

Cranial roots of the accessory nerve exist in the majority of adult humans

Authors

  • R. Shane Tubbs,

    Corresponding author
    1. Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama
    • Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South ACC 400, Birmingham, AL 35233, USA. E-mail: shane.tubbs@childrensal.org

    Search for more papers by this author
  • Brion Benninger,

    1. Department of Medical Anatomical Sciences, Western University of Health Sciences, COMP-NW, Lebanon, Oregon
    2. Orthopedic Department, Samaritan Healthcare, Corvallis, Oregon
    3. General Surgery Department, Samaritan Healthcare, Corvallis, Oregon
    4. Department of Surgery, Oregon Health & Science University, Portland, Oregon
    5. Orthopedics & Rehabilitation, Oregon Health & Science University, Portland, Oregon
    6. Oral Maxillofacial Surgery, Oregon Health & Science University, Portland, Oregon
    Search for more papers by this author
  • Marios Loukas,

    1. Department of Anatomical Sciences, St. George's University, Grenada, West Indies
    Search for more papers by this author
  • Aaron A. Cohen-Gadol

    1. Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, Indiana
    Search for more papers by this author

Abstract

The inclusion of a cranial root as a component of the accessory nerve is controversial with at least one recent study claiming that intracranial rootlets do not exist in humans. In response to this debate, the present study aimed to clarify this anatomy in a large cadaveric sample. In this study, 43 adult cadavers (86 sides) were dissected via a posterior approach to the craniocervical junction. Observations were made for the presence or absence of cranial roots of the accessory nerve, and when present, their lengths and diameters were measured. Relationships of these rootlets were documented. A cranial root of the accessory nerve was identified in 76% of sides. When identified, 1–6 cranial rootlets (mean 4.5) of the accessory nerve were observed. They ranged in diameter from 0.1 to 1.1 mm (mean 0.7 mm). The length of these nerves ranged from 8 to 24 mm with a mean of 17 mm. In general, the more superior rootlets were shorter and the more inferior rootlets were longer. Although there was a slight tendency for the cranial roots to be more numerous and larger on right sides and in males, this did not reach statistical significance. We believe this to be the largest study to date documenting the presence of a cranial root of the accessory nerve. Based on our findings, a cranial root exists in the majority of specimens. Neurosurgical procedures or high quality imaging of this area should enable the physician to see these structures. Clin. Anat. 27:102–107, 2014. © 2012 Wiley Periodicals, Inc.

Get access to the full text of this article

Ancillary