Journal club presentation of lateral pectoral nerve

Journal club

1. Anatomy of Lateral Pectoral Nerve and its Clinical Significance - Original Article Dr Arathy S Junior Resident 3

2. Journal Published: 26-May-2022 Apr-Jun 2022 -  Volume 11 -  Issue 2 Madhavan CM, Rajasekharan S, Varghese S. Anatomy of lateral pectoral nerve and its clinical significance. Natl J Clin Anat 2022;11:79-83.

3. Authors C. Manju Madhavan- Associate Professor, Department of Anatomy, Government TD Medical College, Alappuzha Sreekumar Rajasekharan - Assistant Professor, Department of Anatomy, Government Medical College, Trivandrum Susan Varghese- Associate Professor, Department of Anatomy, Government Medical College, Kollam  

4. Introduction Surgical importance of lateral pectoral nerve (LPN) :

5. What standard text books says about LPN ???

6. Contradictions regarding the number and nomenclature of pectoral nerves Recent studies 1 , three pectoral nerves are described‑ superior, middle and inferior Superior and middle represent LPN (2 numbers) Inferior represents medial pectoral nerve (MPN )

7. Objective To study the anatomy of LPN in terms of : number location course relations branches distribution

8. Materials and methods descriptive study 40 pectoral regions were dissected from 20 embalmed cadavers (18 males and 2 females)

9. Sample size Sample size was calculated using the following formula n = (Z1−α) pq /d2 where p is the lowest percentage of variation in origin of lateral pectoral nerve which is 10% according to Prakash KG et al 2 Sample size thus calculated was too large to be feasible so they conducted a census type study for a duration of 2 years.

10. Dissection of the region was done as per Cunningham’s manual of practical anatomy. After reflecting the skin of the pectoral region, the superficial and deep fasciae over pectoralis major (PM) were removed. Then, the clavicular and sternocostal heads of the muscle were detached from their origins and the muscle was reflected laterally. The plane between the two pectoral muscles and clavipectoral fascia were carefully dissected and the lateral pectoral nerves (LPNs) were identified. The nerves were cleaned without injuring epineurium to avoid misinterpretation of data.

11. David S, Balaguer T, Baque P, Peretti FD, Valla M, Lebreton E, et al. The anatomy of the pectoral nerves and its significance in breast augmentation, axillary dissection and pectoral muscle flaps. J Plast Reconstr Aesthet Surg 2012;65:1193‑8