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Cleidocervical muscle: a mini literature survey of a human muscle variation
Affiliations- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, General Hospital Nuremberg, Nuremberg, Germany
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Abstract
Cleidocervical muscles (CCM) or levator claviculae muscles in humans can be found
as supernumerary unilaterally or bilaterally on the neck attached proximally to the
clavicle and distally to the transverse process of cervical vertebrae at various levels.
Altogether 20 case reports from year 1994 till present including 25 subjects related
to CCM were found and analysed where parameters such as cervical insertion
level, clavicular insertion at the middle vs. lateral third, unilateral vs. bilateral presence
of the muscle, study type, reported gender of the subjects were extracted.
Our literature survey shows that the prevalence of CCM in male and female was
equally presented in radiological studies whereas almost 3-fold higher prevalence
of males was found in cadaver reports. Since body donor system worldwide is
male dominant, a 1:1 proportion of male and female in radiological studies could
show more reality-based distribution of this muscle. Nevertheless, the presentation
of this muscle was found in over 90% of the case reports unilaterally with higher
left sided dominance. Even though the attachment points of CCM varied from
case to case, the proximal attachment was found slightly more frequent on the
middle third of the clavicle whereas the distal insertion was present more often on
the superior cervical vertebrae than the lower ones. With prevalence of CCM in
the population around 2.0–2.5%, the clinical, radiological and surgical relevance
of this variation has to be highlighted to avoid potential misleading diagnostics
in the neck.
Abstract
Cleidocervical muscles (CCM) or levator claviculae muscles in humans can be found
as supernumerary unilaterally or bilaterally on the neck attached proximally to the
clavicle and distally to the transverse process of cervical vertebrae at various levels.
Altogether 20 case reports from year 1994 till present including 25 subjects related
to CCM were found and analysed where parameters such as cervical insertion
level, clavicular insertion at the middle vs. lateral third, unilateral vs. bilateral presence
of the muscle, study type, reported gender of the subjects were extracted.
Our literature survey shows that the prevalence of CCM in male and female was
equally presented in radiological studies whereas almost 3-fold higher prevalence
of males was found in cadaver reports. Since body donor system worldwide is
male dominant, a 1:1 proportion of male and female in radiological studies could
show more reality-based distribution of this muscle. Nevertheless, the presentation
of this muscle was found in over 90% of the case reports unilaterally with higher
left sided dominance. Even though the attachment points of CCM varied from
case to case, the proximal attachment was found slightly more frequent on the
middle third of the clavicle whereas the distal insertion was present more often on
the superior cervical vertebrae than the lower ones. With prevalence of CCM in
the population around 2.0–2.5%, the clinical, radiological and surgical relevance
of this variation has to be highlighted to avoid potential misleading diagnostics
in the neck.
Keywords
cleidocervical, levator claviculae, cleidoatlanticus, scalene muscles
About this articleTitle
Cleidocervical muscle: a mini literature survey of a human muscle variation
Journal
Issue
Article type
Review article
Pages
513-518
Published online
2022-06-22
Page views
970
Article views/downloads
565
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(3):513-518.
Keywords
cleidocervical
levator claviculae
cleidoatlanticus
scalene muscles
Authors
S. Silawal
V. Franke
J. Wehrmann
G. Schulze-Tanzil
References (35)- Alraddadi A. Literature review of anatomical variations: clinical significance, identification approach, and teaching strategies. Cureus. 2021; 13(4): e14451.
- Asad AL, Anteby M, Garip F. Who donates their bodies to science? The combined role of gender and migration status among California whole-body donors. Soc Sci Med. 2014; 106: 53–58.
- Aydoğ ST, Ozçakar L, Demiryürek D, et al. An intervening thoracic outlet syndrome in a gymnast with levator claviculae muscle. Clin J Sport Med. 2007; 17(4): 323–325.
- Bhatnagar K, Smith T. The anomalous human levator claviculae muscle: a case report. Ann Vasc Med Res. 2021; 8(1): 1125.
- Billings HJ, Sherrill WC. A novel variant of the cleidocervicalis muscle with clinical implications for nerve compression/entrapment. Surg Radiol Anat. 2015; 37(6): 697–699.
- Bordoni B, Varacallo M. Anatomy, head and neck, sternocleidomastoid muscle. StatPearls Publishing LLC, Treasure Island (FL) 2022.
- Boyle E, Mahon V, Diogo R. Muscles lost in our adult primate ancestors still imprint in us: on muscle evolution, development, variations, and pathologies. Curr Mol Biol Rep. 2020; 6(2): 32–50.
- Capo JA, Spinner RJ. The levator claviculae muscle. Clin Anat. 2007; 20(8): 968–969.
- Dluzen DE, Brammer CM, Bernard JC, et al. Survey of cadaveric donors to a body donation program: 1978-1993. Clin Anat. 1996; 9(3): 183–192, doi: 10.1002/(SICI)1098-2353(1996)9:3<183::AID-CA10>3.0.CO;2-N.
- Fasel J, Gailloud P, Terrier F. Three-dimensional reconstruction of a levator claviculae muscle. Surg Radiol Anat. 1994; 16(3): 303–305.
- Fazliogullari Z, Cicekcibasi A, Dogan NU, et al. The levator claviculae muscle and unilateral third head of the sternocleidomastoid muscle: case report. Int J Morphol. 2010; 28(3): 929–932.
- Feigl GC, Pixner T. The cleidoatlanticus muscle: a potential pitfall for the practice of ultrasound guided interscalene brachial plexus block. Surg Radiol Anat. 2011; 33(9): 823–825.
- Ferreli F, Mercante G, Spriano G. Levator claviculae muscle: anatomic variation found during neck dissection. Laryngoscope. 2019; 129(3): 634–636.
- Ginsberg LE, Eicher SA. Levator claviculae muscle presenting as a neck mass: CT imaging. J Comput Assist Tomogr. 1999; 23(4): 538–539.
- Gruber W. Archiv fur Anatomie, Physiologie und Wissenschaftliche Medizin. Eichler 1876.
- Gruber W. Vier Abhandlungen aus dem Gebiete der medicinisch-chirurgischen Anatomie. Förstner 1847.
- Habicht JL, Kiessling C, Winkelmann A. Bodies for anatomy education in medical schools: an overview of the sources of cadavers worldwide. Acad Med. 2018; 93(9): 1293–1300.
- Koshy S, Rabi S, Indrasingh I. Supernumerary cleidocervicalis (levator claviculae) muscle: case report of its rare incidence with clinical and embryological significance. Eur J Anat. 2005; 9: 103–106.
- Leon X, Maranillo E, Quer M, et al. Case report: cleidocervical or levator claviculae muscle. A new embryological explanation as to its origin. J Anat. 1995; 187(Pt 2): 503–504.
- Loukas M, Sullivan A, Tubbs RS, et al. Levator claviculae: a case report and review of the literature. Folia Morphol. 2008; 67(4): 307–310.
- Natsis K, Apostolidis S, Nikolaidou E, et al. Levator claviculae muscle: a case report. Cases J. 2009; 2: 6712.
- Odate T, Kawai M, Iio K, et al. Anatomy of the levator claviculae, with an overview and a literature survey. Anat Sci Int. 2012; 87(4): 203–211.
- O'Sullivan ST, Kay SP. An unusual variant of the levator claviculae muscle encountered in exploration of the brachial plexus. J Hand Surg Br. 1998; 23(1): 134–135.
- Raikos A, Paraskevas G, Triaridis S, et al. Bilateral supernumerary sternocleidomastoid heads with critical narrowing of the minor and major supraclavicular fossae: clinical and surgical implications. Int J Morphol. 2012; 30(3): 927–933.
- Rodríguez-Vázquez JF, Mérida-Velasco JR, Verdugo-López S, et al. Anatomical relationships of the cleidoatlanticus muscle. Interpretation about its origin. Anat Sci Int. 2009; 84(1-2): 47–52.
- Rosenheimer JL, Loewy J, Lozanoff S. Levator claviculae muscle discovered during physical examination for cervical lymphadenopathy. Clin Anat. 2000; 13(4): 298–301, doi: 10.1002/1098-2353(2000)13:4<298::AID-CA11>3.0.CO;2-Y.
- Rubinstein D, Escott EJ, Hendrick LL. The prevalence and CT appearance of the levator claviculae muscle: a normal variant not to be mistaken for an abnormality. Am J Neuroradiol. 1999; 20(4): 583–586.
- Rüdisüli T. Demonstration of a musculus levator claviculae. Surg Radiol Anat. 1995; 17(1): 85–87.
- Ruiz Santiago F, López Milena G, Chamorro Santos C, et al. Levator claviculae muscle presenting as a hard clavicular mass: imaging study. Eur Radiol. 2001; 11(12): 2561–2563.
- Saha A, Mandal S, Chakraborty S, et al. Morphological study of the attachment of sternocleidomastoid muscle. Singapore Med J. 2014; 55(1): 45–47.
- Sharir A, Milgram J, Shahar R. Structural and functional anatomy of the neck musculature of the dog (Canis familiaris). J Anat. 2006; 208(3): 331–351.
- Silawal S, Morgan S, Ruecker L, et al. A unilateral sternopharyngeal branch of the sternocleidomastoid muscle in an aged Caucasian male: a unique cadaveric report. Folia Morphol. 2023; 82(2): 434–438.
- Tomo S, Toh H, Hirakawa T, et al. Case report: the cleidocervical muscle with speculation as to its origin. J Anat. 1994; 184(Pt 1): 165–169.
- Wood J, Sharpey W. VII. On a group of varieties of the muscles of the human neck, shoulder, and chest, with their transitional forms and homologies in the mammalia. Philosophical Transactions of the Royal Society of London. 1870; 160: 83–116.
- Zdilla MJ, Aldawood AM, Plata A, et al. Troisier sign and Virchow node: the anatomy and pathology of pulmonary adenocarcinoma metastasis to a supraclavicular lymph node. Autops Case Rep. 2019; 9(1): e2018053.
