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Anatomic landmarks for the cervical portion of the thoracic duct
Kevin Ammar1, R Shane Tubbs, Matthew D Smyth
1Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA.
Objective:
Avoidance of injury to the thoracic duct during neurosurgical procedures involving the cervical region depends on a working knowledge of its location. This study evaluates superficial anatomic landmarks for the cervical portion of the thoracic duct that may be encountered in neurosurgery of the neck.
Methods:
Fifteen dissections of human cadavers were performed to study the relationship between the proximal thoracic duct and superficial landmarks (e.g., the cricoid cartilage and sternal notch of the manubrium).
Results:
The cervical portion of the thoracic duct was found to be approximated by a roughly 4.4-cm(2) region in the left supraclavicular area beginning approximately 2.0 cm lateral to the midline and 3.5 cm superior to the sternal notch, extending superiorly to a point roughly 3.5 cm from the midline and 2.5 cm inferior to the cricoid cartilage, and terminating within the venous system at a point approximately 4.5 cm lateral to the midline and 3.0 cm superior to the sternal notch.
Conclusion:
Through an increased appreciation for its location, injury to the thoracic duct may be minimized.