Visceral cervical fascia

The visceral cervical fascia refers to the visceral layer of the pretracheal fascia.

• The visceral part encloses the thyroid and parathyroid glands, trachea, and esophagus, forming a fascial compartment that supports these structures and allows smooth gliding during swallowing and neck movement.

• Superiorly, it attaches to the thyroid cartilage and cricoid cartilage, while inferiorly, it descends into the thorax, blending with the fibrous pericardium.

• Posteriorly, the visceral part continues as the buccopharyngeal fascia, which covers the posterior surface of the pharynx and separates it from the retropharyngeal space.

• Laterally, the pretracheal fascia blends with the carotid sheath.

Functions

Functionally, the visceral cervical fascia allows free movement of the trachea, esophagus, and larynx during swallowing and neck motion. By enclosing the visceral structures of the neck—including the trachea, esophagus, larynx, and thyroid gland—the visceral layer of the pretracheal fascia provides both support and containment, acting as a protective barrier to the spread of infection. However, when infection develops deep to this fascial layer, particularly within the retropharyngeal space, it may extend inferiorly into the superior or anterior mediastinum owing to the continuity of the fascial planes with the thoracic fascia.