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Use of the Triangle of Farabeuf for Neurovascular Procedures of the Neck

R. Shane Tubbs, Mark Rasmussen, Marios Loukas, Mohammadali M. Shoja, Martin Mortazavi, Aaron A. Cohen-Gadol

Abstract


Surgical landmarks for application during surgery of the neck may be useful to the neurosurgeon. The present study was performed to explore the utility of a nearly forgotten anatomical triangle of the neck, the triangle of Farabeuf (TF) formed by the common facial and internal jugular veins and the hypoglossal nerve as its base directly superiorly. This study was carried out on 12 (24 sides) formaldehyde-fixed adult human cadavers (5 males and 7 female. The presence of TF was documented and measurements made of its sides. Additionally, structures found within the triangle were observed. TF was present on 15 sides and absent on 5 sides. The TF, when present, contained at least the proximal internal or external carotid artery in 14 of the 15 sides (93.3%), and both in 6 of the sides (40%). The carotid bifurcation was present in the triangle on 2 sides (13.3%) and was located inferior to the TF in the other cases. A jugulodigastric node was found in the TF on 8 sides (33%). The mean length of the TF for inferior, superior and posterior legs of the triangle was 1.05 cm, 1.58 cm, and 1.92 cm, respectively. We found that the proximal common facial vein was up to 2 cm superior to or 1.5 cm inferior to the common carotid artery bifurcation. Knowledge of the TF may be of use to the surgeon during procedures of the neck such as placement of ventriculoatrial shunts into the common facial vein or neurotization procedures utilizing the hypoglossal nerve. Carotid endarterectomy may be performed by traversing the TF to access the proximal internal carotid artery.       

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