FASCIAL SPACES OF THE NECK: ANATOMICAL ORGANIZATION AND TOPOGRAPHY.

Abstract

The neck is a densely-packed anatomical region with many layers of fascia which become divided into compartments called fascial spaces. These areas are set up to be organized conduits for blood vessels, nerves and visceral organs with a clear topography. This narrative review discusses how the cervical fascia is organized according to its shape and the fascial spaces it creates, highlighting normal human anatomy as well as correct terminology to correspond to Terminologia Anatomica. A variety of peer-reviewed studies and well-established anatomical atlases were interpreted to obtain an elaborate description of the fascial layers, such as investing layer of the deep cervical fascia (lamina superficialis), pretracheal layer (lamina pretrachealis), and prevertebral layer (lamina prevertebralis). In addition, organization of the carotid sheath itself and important fascial spaces namely retropharyngeal, danger, parapharyngeal and visceral spaces is discussed. The layered structure of those fascial compartments demonstrates the principle of topographic anatomy as well as the definition of the structural boundaries which are necessary in order to understand the spatial relationships in the cervical region. The importance of having a good grasp on the anatomy of cervical fascial structures is supported for medical students, who would be better served by a systematic approach to training in the regional anatomy area.