open access

Vol 82, No 3 (2023)
Case report
Submitted: 2022-05-27
Accepted: 2022-06-13
Published online: 2022-07-08
Get Citation

A unique variation of a four-bellied digastric muscle named “real quadrigastric muscle”: a case report and literature review

B. Landzhov1, L. Gaydarski1, R. S. Tubbs2, V. Kirkov3, G. P. Georgiev4
·
Pubmed: 35818809
·
Folia Morphol 2023;82(3):735-739.
Affiliations
  1. Department of Anatomy, Histology and Embryology, Medical University of Sofia, Bulgaria
  2. Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, United States
  3. Department of Health Policy and Management, Medical University of Sofia, Bulgaria
  4. Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna – ISUL, Medical University of Sofia, Bulgaria

open access

Vol 82, No 3 (2023)
CASE REPORTS
Submitted: 2022-05-27
Accepted: 2022-06-13
Published online: 2022-07-08

Abstract

From a topographical standpoint, the digastric muscle is key to the formation of
several triangles of the neck, which are of the utmost clinical significance. Herein,
we present a previously unrecognised variation of the digastric muscle: a quadrigastric
muscle with two accessory bellies originating from the body and angle of
the mandible and inserting to the intermediate tendon. Three new triangles are
demarcated between the four bellies of the aberrant muscle. Detailed knowledge
of variations of the digastric muscle, changing the borders and relationships of
the topographic triangles, is paramount for radiologists and surgeons operating
on the anterior region of the neck.

Abstract

From a topographical standpoint, the digastric muscle is key to the formation of
several triangles of the neck, which are of the utmost clinical significance. Herein,
we present a previously unrecognised variation of the digastric muscle: a quadrigastric
muscle with two accessory bellies originating from the body and angle of
the mandible and inserting to the intermediate tendon. Three new triangles are
demarcated between the four bellies of the aberrant muscle. Detailed knowledge
of variations of the digastric muscle, changing the borders and relationships of
the topographic triangles, is paramount for radiologists and surgeons operating
on the anterior region of the neck.

Get Citation

Keywords

neck topography, novel triangles, clinical significance

About this article
Title

A unique variation of a four-bellied digastric muscle named “real quadrigastric muscle”: a case report and literature review

Journal

Folia Morphologica

Issue

Vol 82, No 3 (2023)

Article type

Case report

Pages

735-739

Published online

2022-07-08

Page views

1022

Article views/downloads

544

DOI

10.5603/FM.a2022.0063

Pubmed

35818809

Bibliographic record

Folia Morphol 2023;82(3):735-739.

Keywords

neck topography
novel triangles
clinical significance

Authors

B. Landzhov
L. Gaydarski
R. S. Tubbs
V. Kirkov
G. P. Georgiev

References (24)
  1. Béclard PA, Knox R. Third section. Of the external muscles. In: Knox R (ed). Elements of general anatomy. MacLachlan and Stewart, Edinburgh 1830: 311–321.
  2. Celik HH, Aldur MM, Ozdemir B, et al. Abnormal digastric muscle with unilateral quadrification of the anterior belly. Clin Anat. 2002; 15(1): 32–34.
  3. De-Ary-Pires B, Ary-Pires R, Pires-Neto MA. The human digastric muscle: patterns and variations with clinical and surgical correlations. Ann Anat. 2003; 185(5): 471–479.
  4. Harvey JA, Call Z, Peterson K, et al. Weave pattern of accessory heads to the anterior digastric muscle. Surg Radiol Anat. 2015; 37(8): 1001–1004.
  5. Hitier M, Zhang M, Labrousse M, et al. Persistent stapedial arteries in human: from phylogeny to surgical consequences. Surg Radiol Anat. 2013; 35(10): 883–891.
  6. Hsiao TH, Chang HP. Anatomical variations in the digastric muscle. Kaohsiung J Med Sci. 2019; 35(2): 83–86.
  7. Jamieson GG. Head and neck operations. In: Jamieson GG (ed). Anatomy of general surgical operations, 2nd ed. Churchill Livingstone/Elsevier, Edinburgh 2006: 1–240.
  8. Kikuta S, Iwanaga J, Kusukawa J, et al. Triangles of the neck: a review with clinical/surgical applications. Anat Cell Biol. 2019; 52(2): 120–127.
  9. Kim SD, Loukas M. Anatomy and variations of digastric muscle. Anat Cell Biol. 2019; 52(1): 1–11.
  10. Larsson SG, Lufkin RB. Anomalies of digastric muscles: CT and MR demonstration. J Comput Assist Tomogr. 1987; 11(3): 422–425.
  11. Lee HY, Yang HE. Anterior neck muscles. In: Tubbs RS, Shoja MM, Loukas M (eds.) Bergman's comprehensive encyclopedia of human anatomic variation, 1st ed. Wiley & Sons, Hobokken, New Jersey 2016: 228.
  12. Macalister A. Additional observations on muscular anomalies in human anatomy (third series), with a catalogue of the principal muscular variations hitherto published. Trans Roy Irish Acad Sci. 1875; 25(1): 1–134.
  13. Mori M. Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn. 1964; 40: 195–300.
  14. Natsis K, Piagkou M, Vrochidis P, et al. Unilateral asymmetrical anterior bellies of the digastric muscle in coexistence with accessory muscle bundles in the submental triangle: A rare case report. Morphologie. 2018; 102(337): 83–86.
  15. Ozgur Z, Govsa F, Ozgur T. The cause of the difference in the submental region: aberrant muscle bundles of the anterior belly of the digastric muscle. J Craniofac Surg. 2007; 18(4): 875–881.
  16. Ozgur Z, Govsa F, Ozgur T. Bilateral quadrification of the anterior digastric muscles with variations of the median accessory digastric muscles. J Craniofac Surg. 2007; 18(4): 773–775.
  17. Pirogoff NI. Sectiones capitis, colli et columne vertebrarum triplici directioneductae. In: Pirogoff NI (ed.) Anatome topographica sectionibus per corpus humanum congelatum. Triplice directione ductis illustrate. First Ed. Typis Jacobi Trey, St. Petersburg 1852: 1–248.
  18. Sadler TW. Head and neck. In: Sadler TW (ed.) Langman's medical embryology, 10th ed. Lippincott Williams & Wilkins, Philadelphia 2006: 259–261.
  19. Standring S. Head and neck. In: Standring S (ed.) Gray’s Anatomy. The Anatomical Basis of Clinical Practice, 40th ed. Churchill Livingstone/Elsevier, Edinburgh 2008: 437.
  20. Tan ST. Anterior belly of digastric muscle transfer: a useful technique in head and neck surgery. Head Neck. 2002; 24(10): 947–954.
  21. Tubbs RS, Rasmussen M, Loukas M, et al. Three nearly forgotten anatomical triangles of the neck: triangles of Beclard, Lesser and Pirogoff and their potential applications in surgical dissection of the neck. Surg Radiol Anat. 2011; 33(1): 53–57.
  22. Uzun A, Aluclu A, Kavakli A. Bilateral accessory anterior bellies of the digastric muscle and review of the literature. Auris Nasus Larynx. 2001; 28(2): 181–183.
  23. Yamada S. Beobachtungen über den Venter anterior des Musculus digastricus mandibulae bei japanischen Erwachsenen und Foeten. Acta Anat Nippon. 1935; 8(1): 303–347.
  24. Žlábek K. Contribution à la connaissance des anomalies du ventreantérieur du digastrique de l'Homme. Arch Anat Histol Embryol. 1933; 16: 357–406.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl