Determination of the origin of the greater occipital nerve for the treatment of occipital neuralgia: an anatomical study

Öz

Aim: Blockade of the greater occipital nerve is a proven approach for managing occipital neuralgia. This condition, characterized by pain in the occipital region, often caused by compression of the greater occipital nerve. Understanding the exact exit point of the greater occipital nerve to the surface is crucial to avoid complications and to ensure safe and effective nerve block procedures. Method: In the present study 15 adult cadavers (5 females and 10 males) fixed with formaldehyde, were bilaterally dissected to evaluate the greater occipital nerve. The greater occipital nerve was found at the point where it pierced the trapezius muscle or its aponeurosis to reach the surface. The diameter of the nerve at the piercing point, the distance from this point to midline, and the distance from piercing point to the external occipital protuberance were measured with a digital caliper. Comparisons were made between gender and side. Results: The average diameter of the nerve at the piercing point was detected to be 3.7 mm, the distance from the piercing point to the midline was 44.4 mm, and the distance from piercing point to the external occipital protuberance was 17.5 mm. Statistically significant differences were observed between sides and genders. Conclusion: In the present study, data that have not been previously reported in the literature were obtained. These findings are thought to help clinicians in planning possible treatment interventions for occipital neuralgia involving this nerve.

Anahtar Kelimeler

• Greater occipital nerve
• nerve block
• occipital neuralgia
• morphometry
• anatomy

Oksipital nevralji tedavisi için nervus occipitalis major sinirinin çıkış noktasının belirlenmesi: anatomik çalışma

Öz

Amaç: Nervus occipitalis major blokajı, oksipital nevralji tedavisi için kanıtlanmış bir yaklaşımdır. Oksipital bölgede ağrı ile karakterize olan bu durum, genellikle nervus occipitalis major'un sıkışmasından kaynaklanır. Bu sinirin yüzeye tam çıkış noktasını bilmek, komplikasyonlardan kaçınmak, güvenli ve etkili sinir bloğu prosedürlerini sağlamak için çok önemlidir. Yöntem: Buçalışmada 15 yetişkin kadavra (beş kadın ve 10 erkek, formaldehit ile fikse edilmiş) nervus occipitalis major'u değerlendirmek için bilateral olarak diseke edildi. Sinir, musculus trapezius’u veya aponevrozunu delerek yüzeye çıktığı noktada bulundu. Sinirin bu noktadaki çapı, yüzeye çıktığı noktanın orta hatta olan mesafesi ve bu noktanın protuberentia occipitalis externa’ya olan mesafesi, dijital bir kumpasla ölçüldü. Cinsiyet ve taraf karşılaştırmaları yapıldı. Bulgular: Sinirin yüzeye ulaştığı yerdeki ortalama çapı 3.7 mm, noktanın orta hatta olan mesafesi44.4 mm, bu delme noktasının protuberentia occipitalis externa’ya olan mesafesi17.5 mm olarak bulundu. Taraf ve cinsiyet karşılaştırmalarında istatistiksel olarak anlamlı farklılıklar gözlendi. Sonuç: Bu çalışmada, literatürde bildirilmeyen veriler elde edildi. Bu sinir için planlanan, olası bir oksipital nevralji tedavisi yaklaşımı için klinisyenlere yardımcı olacağı düşünülmektedir.

Anahtar Kelimeler

• Nervus occipitalis major
• sinir bloğu
• oksipital nevralji
• morfometri
• anatomi

Kaynakça

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