Fascia and spaces on the neck: myths and reality

medicina fluminensis 2015, Vol. 51, No. 4, p. 430-439 430 Abstract. The ongoing discussion concerning the interpretation of existing or not existing fasciae on the neck needs a clarification and a valid terminology. Based on the dissection experience of the last four decades and therefore of about 1000 cadavers, we investigated the fascias and spaces on the neck and compared it to the existing internationally used terminology and interpretations of textbooks and publications. All findings were documented by photography and the dissections performed on cadavers embalmed with Thiel ́s method. Neglected fascias, such as the intercarotid fascia located between both carotid sheaths and passing behind the visceras or the Fascia cervicalis media as a fascia between the two omohyoid muscles, were dissected on each cadaver. The ”Danger space” therefore was limited by fibrous walls on four sides at level of the carotid triangle. Ventrally there was the intercarotid fascia, laterally the alar fascia, and dorsally the prevertebral fascia. The intercarotid fascia is a clear fibrous wall between the Danger Space and the ventrally located retropharyngeal space. Latter space has a continuation to the pretracheal space which is ventrally limited by the middle cervical fascia. The existence of an intercarotid fascia is crucial for a correct interpretation of any bleeding or inflammation processes, because it changes the topography of the existing spaces such as the retropharyngeal or “Danger space” as well. As a consequence, the existing terminology should be discussed and needs to be adapted.