Type:
Educational Exhibit
Authors:
H. Verma, N. Bharwani, P. Skippage, E. Goldstraw, S. Brown, E. J. Adam; London/UK
DOI:
10.1594/ecr2008/C-525
Background
Comprehension of the soft tissue spaces of the head and neck is often challenging. A brief overview of the anatomy is discussed before acompartmental approach is used.
- The neck is defined from the hard palate to the sternum & clavicles.
- It is divided into anterior and posterior compartments by sternocleidomastoid.
- The hyoid further divides it into supra and infrahyoid neck.
- The posterior compartment is divided by the inferior belly of omohyoid into:
-
- superior infraoccipital
- inferior subclavian
The Aerodigestive Tract
This is classically divided into the nasopharynx, oropharynx, oral cavity, hypopharynx and larynx. These terms are useful particularly in the staging of squamous cell carcinoma .
![](https://epos.myesr.org/posterimage/esr/ecr2008/28987/media/224832?maxheight=300&maxwidth=300)
Fig.: Figure 1. Sagittal MR showing the normal upper aerodigestive tract and its major subdivisions.
Nasopharynx:
- tubular structure
- from clivus and posterior nasal cavity down to the level of the soft palate
Oropharynx:
- lies posterior to the oral cavity and extends inferiorly from the level of the soft palate.
- is separated from larynx by the epiglottis and glossoepiglotic fold, and from hypopharynx by pharyngoepiglottic fold.
- starts anteriorly from circumvallate papillae of tongue and includes the lingual tonsils.
Larynx:
- its supporting structures are cricoid, thyroid and arytenoid cartilages
The Fascial Layers
These are
The deep cervical fascia is further divided into
- superficial (investing)
- middle (buccopharyngeal in supra-hyoid neck, visceral in infra-hyoid neck)
- deep (prevertebral)
The layers of the deep fascia surround the entire anatomical contents of the neck to define the fascial spaces throughout the neck.
![](https://epos.myesr.org/posterimage/esr/ecr2008/28987/media/220711?maxheight=300&maxwidth=300)
Fig.: Figure 2. Schematic diagram illustrates (a) major muscles of the neck, (b) anterior and posterior compartments and (c) the division of the supra and infra hyoid neck.
Compartments within the suprahyoid neck are:
- parapharyngeal space
- pharyngeal mucosal space
- masticator space
- parotid space
- carotid space
- retropharyngeal space
- perivertebral space (including the prevertebral & paraspinal compartments
Compartments within the infrahyoid neck are:
- carotid space
- posterior cervical space
- visceral space
- retropharyngeal space
- perivertebral space