Re-examination of the medullary rootlets of the accessory and vagus nerves

The vagus (X) and cranial root of the accessory nerve (crXI) are traditionally described as arising from a series of rootlets from the medulla oblongata. Descriptions of the number of rootlets vary, and the existence of the crXI is contested. Here we report the results of dissections in six embalmed adult human specimens (11 sides). The rootlets forming the vagus were counted at three positions. At emergence from the brainstem there were between 12 and 21 rootlets, at the jugular foramen the range was 12-17, and midway between these two points it was 6-12. In addition, the origin of the most caudal X rootlet (cX) and the most rostral XI rootlet (rXI) was recorded in relation to the spino-medullary junction, defined as the caudal border of the olivary eminence. The position of the cX varied between -1 and +8 mm (median = +2 mm on left, +3.75 mm on right). The rXI varied between -5 and +7 mm (median = -0.5 mm on left, +1.75 mm on right). In five sides, rXI was above the caudal border of the olivary eminence and as such can be defined as being of cranial origin. These observations show the arrangement of rootlets contributing to the vagus to be more complex than what was described previously and provide evidence for the variable existence of a cranial root of the accessory nerve.