Pretterklieber, Bettina ORCID: 0000-0002-8015-0740, Hader, Maria, Hammer, Niels, Pryymachuk, Galyna, Proels, Felicitas, Vielmuth, Franziska, Barnerssoi, Miriam, Cotofana, Sebastian, Custozzo, Amanda, Weyers, Imke, Wedel, Thilo ORCID: 0000-0002-8146-2711, Arnold, Philipp, Rahner, Christoph, Mueller-Gerbl, Magdalena and Pretterklieber, Michael L. (2020). When and why was the phrenicoabdominal branch of the left phrenic nerve placed into the esophageal hiatus in German textbooks of C anatomy? An anatomical study on 400 specimens reevaluating its course through the diaphragm. Ann. Anat.-Anat. Anz., 227. MUNICH: ELSEVIER GMBH. ISSN 1618-0402

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Abstract

Background: The phrenicoabdominal branch of the left phrenic nerve passes between muscle fiber bundles within the costal part of the diaphragm near the pericardium. In most German textbooks of anatomy, however, its passage is described to be found in the esophageal hiatus. The aim of this study was to reevaluate its topography relative to the diaphragm in a multicentric study and to identify the initiation of this description. Methods: In this multicentric study, the most dorsomedial branch of the left phrenic nerve was identified as the phrenicoabdominal branch in 400 embalmed anatomic specimens of Caucasian origin. The distance between its passage and the apex of the pericardium, the left border of the esophageal hiatus, and the inner aspect of the left sixth rib was measured on the cranial aspect of the diaphragm. Textbooks on human anatomy published in German language between 1700 and 2018 were reviewed for their description of the passage of the left phrenicoabdominal branch through the diaphragm. Results: The first statement on the passage of the left phrenicoabdominal branch through the esophageal hiatus was given in 1791 by Sommering. Since then, in German textbooks of anatomy, a duality in the description of the passage of the left phrenicoabdominal branch persists. In none of the individuals examined in this study, the left phrenicoabdominal branch passed through the esophageal hiatus. In 99.5% of all cases, it pierced the costal part of the diaphragm dorsal to or at the same level as the apex of the pericardium. The mean distances (standard deviations) were 3.4 (+/- 1.5) cm to the apex of the pericardium, 5.8 (+/- 2.2) cm to the esophageal hiatus, and 5.5 (+/- 1.6) cm to the inner aspect of the left sixth rib. Conclusion: The findings on the position of the left phrenicoabdominal branch relative to the diaphragm help to improve topographical knowledge and prevent inadvertent nerve injury during surgical interventions on or near the diaphragm. Further to this, these results may form a substantial basis to adopt the correct description of the passage of the left phrenicoabdominal branch to anatomical textbook knowledge. (C) 2019 Elsevier GmbH. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Pretterklieber, BettinaUNSPECIFIEDorcid.org/0000-0002-8015-0740UNSPECIFIED
Hader, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hammer, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pryymachuk, GalynaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Proels, FelicitasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vielmuth, FranziskaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barnerssoi, MiriamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cotofana, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Custozzo, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weyers, ImkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wedel, ThiloUNSPECIFIEDorcid.org/0000-0002-8146-2711UNSPECIFIED
Arnold, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rahner, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller-Gerbl, MagdalenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pretterklieber, Michael L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-350756
DOI: 10.1016/j.aanat.2019.151415
Journal or Publication Title: Ann. Anat.-Anat. Anz.
Volume: 227
Date: 2020
Publisher: ELSEVIER GMBH
Place of Publication: MUNICH
ISSN: 1618-0402
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ASSISTED THORACIC-SURGERY; INNERVATION; CRURAMultiple languages
Anatomy & MorphologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/35075

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