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Published online: 2019-01-18
Submitted: 2018-12-09
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Accessory muscles of the anterior thoracic wall and axilla. Cadaveric, surgical and radiological incidence and clinical significance during breast and axillary surgery

Stergios Douvetzemis, Konstantinos Natsis, Maria Piagkou, Michalis Kostares, Theano Demesticha, Theodore Troupis
DOI: 10.5603/FM.a2019.0005
·
Pubmed: 30664230

open access

Ahead of Print
REVIEW ARTICLES
Published online: 2019-01-18
Submitted: 2018-12-09
Accepted: 2018-12-23

Abstract

Background: The present study aims to summarize the accessory muscles of the anterior thoracic wall and axilla that can be encountered during breast and axillary surgery and record their incidence and clinical significance. Moreover, the laterality of the atypical muscles is highlighted and possible gender dimorphism is referred. Accessory anterior thoracic wall muscles include: Langer’s axillary arch, sternalis muscle, chondrocoracoideus muscle, chondroepitrochlearis, chondrofascialis, pectoralis minimus, pectoralis quartus and pectoralis intermedius.

Materials and Methods: The anatomical, surgical and radiological literature has been reviewed and an anatomical study on 48 Greek adult cadavers was performed.

Results: Literature review revealed that there are accessory muscles of the anterior thoracic wall and axilla that have a significant incidence that can be considered high and may, therefore, have clinical significance. For the most common of these muscles, which are Langer’s axillary arch and sternalis muscle, the cadaveric incidence is 10.30% and 7.67%, respectively. In the current cadaveric study, accessory thoracic wall muscles were identified in two cadavers; namely a bilateral sternalis muscle (incidence 2.08%) extending both to the anterior and posterior surface of the sternum and a left-sided chondrocoracoideus muscle (of Wood) (incidence 2.08%).

Conclusions: Despite the fact that accessory anterior thoracic wall and axillary muscles are considered to be rare, it is evident that the incidence of at least some of them is high enough to encounter them in clinical practice. Thus, clinicians’ awareness of these anatomical structures is advisable.

Abstract

Background: The present study aims to summarize the accessory muscles of the anterior thoracic wall and axilla that can be encountered during breast and axillary surgery and record their incidence and clinical significance. Moreover, the laterality of the atypical muscles is highlighted and possible gender dimorphism is referred. Accessory anterior thoracic wall muscles include: Langer’s axillary arch, sternalis muscle, chondrocoracoideus muscle, chondroepitrochlearis, chondrofascialis, pectoralis minimus, pectoralis quartus and pectoralis intermedius.

Materials and Methods: The anatomical, surgical and radiological literature has been reviewed and an anatomical study on 48 Greek adult cadavers was performed.

Results: Literature review revealed that there are accessory muscles of the anterior thoracic wall and axilla that have a significant incidence that can be considered high and may, therefore, have clinical significance. For the most common of these muscles, which are Langer’s axillary arch and sternalis muscle, the cadaveric incidence is 10.30% and 7.67%, respectively. In the current cadaveric study, accessory thoracic wall muscles were identified in two cadavers; namely a bilateral sternalis muscle (incidence 2.08%) extending both to the anterior and posterior surface of the sternum and a left-sided chondrocoracoideus muscle (of Wood) (incidence 2.08%).

Conclusions: Despite the fact that accessory anterior thoracic wall and axillary muscles are considered to be rare, it is evident that the incidence of at least some of them is high enough to encounter them in clinical practice. Thus, clinicians’ awareness of these anatomical structures is advisable.

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Keywords

accessory muscle, sternalis, axillary arch, chondrocoracoideus, chondroepitrochlearis, chondrofascialis, pectoralis minimus, pectoralis quartus, pectoralis intermedius, variation

About this article
Title

Accessory muscles of the anterior thoracic wall and axilla. Cadaveric, surgical and radiological incidence and clinical significance during breast and axillary surgery

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2019-01-18

DOI

10.5603/FM.a2019.0005

Pubmed

30664230

Keywords

accessory muscle
sternalis
axillary arch
chondrocoracoideus
chondroepitrochlearis
chondrofascialis
pectoralis minimus
pectoralis quartus
pectoralis intermedius
variation

Authors

Stergios Douvetzemis
Konstantinos Natsis
Maria Piagkou
Michalis Kostares
Theano Demesticha
Theodore Troupis

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