Diagnosing a soft tissue tumor in the head and neck region can be challenging due to its complex anatomy and diverse histological spectrum. This case report highlights the case of a woman who presented with a painless neck lump in the posterior triangle of the neck. Various pathological and imaging studies were suggestive of pleomorphic adenoma, which arises from the left prevertebral space. The patient underwent complete surgical excision via the transcervical approach. Pleomorphic adenoma in the posterior triangle of the neck is extremely rare and causes a diagnostic dilemma in managing soft tissue tumors of the neck.

Carotid endarterectomy (CEA) is usually performed using the anterior cervical triangle as a surgical corridor but, when needed, the retromandibular space makes dissection of higher structures difficult in some cases. The posterior cervical triangle (PCT) can be useful in these demanding cases.
We retrospectively reviewed cases from July 2013 to November 2019 in which PCT was used as an approach for CEA. The surgical technique used was explained, and the complications and evolution of the patients were analysed.
We found 7 CEAs performed through this approach, of which 2 presented transient trapezius paresis. There were no cases of severe complications in this series.
The PCT approach for performing CEA represents a useful and easy technique that avoids the need for mandibular mobilisation or osteotomies for lesions located in anatomically high carotid bifurcations.

We describe a case in which a cutaneous branch was found arising from the spinal accessory nerve, a nerve typically characterized as a purely motor nerve. Although reported anatomical variations of the lesser occipital and spinal accessory nerves are uncommon, rare variants have been reported. Such anatomy might result in unexpected patient presentations or rare complications following spinal accessory nerve injury.

OBJECTIVE: To characterize the anatomical features of a large unnamed nerve in the posterior cervical triangle and clarify its relationship with the lesser occipital nerve.
METHODS: We dissected 31 adult formalin-fixed cadaver head and neck specimens (62 sides). The lateral cervical region, the anterior cervical region, the sternocleidomastoid region, and the occipital region were dissected to define the anatomical features of the unnamed nerve.
RESULTS: This unnamed nerve was identified in the posterior cervical triangle in 96.8% of the specimens. The main trunk of the nerve had a diameter of about 3 mm with a length of around 10 cm. The nerve arose from the anterior branch of the second cervical nerve (C2, C2-3), entered the posterior cervical triangle at 1-3 cm above the accessory nerve, and continued to ascend along or in parallel with the posterior border of the sternocleidomastoid muscle. It passed between the attachments of the sternocleidomastoid and the trapezius to the occiput and divided into 3-5 branches, which innervated the skin area between the lesser and greater occipital nerves.
CONCLUSIONS: We identified a large unnamed nerve in the posterior cervical triangle, for which we coined the name \"long occipital nerve\" based on its unique anatomical features. The discovery of this nerve can be important for local surgery and for diagnosis and treatment of related diseases.

OBJECTIVE: A broad armamentarium of microsurgical techniques affords flexibility to surgeons when choosing a procedure that is best tailored to fit the anatomy of an individual. Herein, we report on the feasibility of using the deep cervical artery (DCA) to revascularize the vertebral artery (VA) via a DCA-V3 bypass graft.
METHODS: Fourteen DCAs from 7 injected cadaveric heads were located and traced. The diameter of the main trunk of the DCA was measured bilaterally at the C3 level. The proximal vertebral branches of each DCA were then severed and the main trunk of the DCA was transposed superiorly onto the V3 segment of the VA, which was also exposed bilaterally.
RESULTS: The DCA was identified and traced bilaterally on all specimens. The diameter of the main trunk of the DCA at the C3 level ranged from 1.03 to 2.79 mm. The mean diameter of the main trunk of the DCA at this level was found to be 1.52 ± 0.60 mm for the right side and 1.46 ± 0.54 mm for the left side. After releasing the proximal vertebral branches of the DCA, all arteries were able to be transposed to the ipsilateral VA.
CONCLUSIONS: Based on the mean diameter of the DCA reported in extant literature and this study, the blood flow volume of the DCA makes it a viable candidate to bypass the proximal VA.