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open access eISSN 2093-3673

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Original Article

Anat Cell Biol 2023; 56(3): 350-359

Published online September 30, 2023


Copyright © Korean Association of ANATOMISTS.

An anatomical investigation of the suboccipital- and inferior suboccipital triangles

Kirsten Shannon Regan , Gerda Venter

Department of Anatomy, Faculty of Medicine, University of Pretoria, Pretoria, South Africa

Correspondence to:Gerda Venter
Department of Anaotmy, Faculty of Medicine, University of Pretoria, Prinshof Campus, Pretoria 0001, Gauteng, South Africa
E-mail: gerda.venter@up.ac.za

Received: January 19, 2023; Revised: March 9, 2023; Accepted: March 20, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The suboccipital triangle (ST) is a clinically relevant landmark in the posterior aspect of the neck and is used to locate and mobilize the horizontal segment of the third part of the vertebral artery before it enters the cranium. Unfortunately, this space is not always a viable option for vertebral artery exposition, and consequently a novel triangle, the inferior suboccipital triangle (IST) has been defined. This alternative triangle will allow surgeons to locate the artery more proximally, where its course is more predictable. The purpose of this study was to better define the anatomy of both triangles by measuring their borders and calculating their areas. Ethical clearance was obtained from the University of Pretoria (reference number: 222/2021) and both triangles were subsequently dissected out on both the left and right sides of 33 formalin-fixed human adult cadavers. The borders of each triangle were measured using a digital calliper and the areas were calculated using Herons Formula. The average area of the ST is 969.82±153.15 mm2, while the average area of the IST is 307.48±41.31 mm2. No statistically significant differences in the findings were observed between the sides of the body, ancestry, or sex of the cadavers. Measurement and analysis of these triangles provided important anatomical information and speak to their clinical relevance as surgical landmarks with which to locate the vertebral artery. Of particular importance here is the IST, which allows for mobilisation of this artery more proximally, should the ST be occluded.

Keywords: Cervical vertebrae, Inferior suboccipital triangle, Obliquus capitis inferior, Suboccipital triangle, Vertebral artery

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