scholarly journals A practical suggestion on functional neck dissection with preservation of spinal accessory nerve and cervical plexus

1995 ◽  
Vol 5 (2) ◽  
pp. 185-192
Author(s):  
Wataru Nishijima
2021 ◽  
Vol 6 (4) ◽  
pp. 539-541
Author(s):  
Rohit Jindal ◽  
Kamal Kishor Lakhera ◽  
Pinakin Patel ◽  
Suresh Singh ◽  
Ravinder Singh Gothwal ◽  
...  

Prevention of the spinal accessory nerve (SAN) is an indispensable aspect of the functional neck dissection surgery to avoid highly disabling shoulder syndrome postoperatively. This requires comprehensive knowledge of the anatomy of SAN and its variations. Rare anatomical variations like SAN duplication can result in an inadvertant injury to the SAN. We report a case of duplication of SAN, which was encountered while doing a functional neck dissection surgery for oral squamous cell carcinoma. No iatrogenic injury occurred during the surgery and neither there was any SAN dysfunction post-operatively. Meticulous dissection and consistent identification of SAN, along with vast anatomical knowledge is the key to the preservation of the nerve during the surgery. This report aims to broaden our anatomical knowledge of SAN and also discuss the clinical implications and literature pertaining to the duplication of SAN.


2009 ◽  
Vol 129 (8) ◽  
pp. 872-880 ◽  
Author(s):  
Murat Karaman ◽  
Arman Tek ◽  
Celi˙l Uslu ◽  
Davut Akduman ◽  
Ömer Bi˙laç

Toukeibu Gan ◽  
2008 ◽  
Vol 34 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Tetsuro Onitsuka ◽  
Mitsuru Ebihara ◽  
Yoshiyuki Iida ◽  
Tomoyuki Kamijyo ◽  
Rie Asano ◽  
...  

2006 ◽  
Vol 121 (1) ◽  
pp. 44-48 ◽  
Author(s):  
K S Orhan ◽  
T Demirel ◽  
B Baslo ◽  
E K Orhan ◽  
E A Yücel ◽  
...  

The aim of this study was to evaluate spinal accessory nerve function after functional neck dissection (FND) and radical neck dissection (RND) by monitoring the nerve with electromyographic (EMG) examinations. A prospective, double-blind, clinical study was undertaken in 21 patients (42 neck side dissections) operated on for head and neck malignant diseases, separated into two groups: 10 neck sides in the RND group and 32 neck sides in the FND group. Electromyographic examinations were performed pre-operatively and post-operatively in the third week and third and ninth months. Additionally, a questionnaire, modified from the neck dissection impairment index, was applied to all the patients in order to assess shoulder function in the ninth post-operative month.All patients had maximum EMG scores pre-operatively. Following the operation, motor amplitudes decreased in both groups. At the third post-operative month, amplitudes decreased to their lowest values. As expected, the decreases in amplitude and EMG score were more prominent in the RND group. Following reinnervation, the amplitudes of the trapezius motor response increased in the FND group but never reached pre-operative values (during the time of follow up). The FND group scores for pain, neck and shoulder stiffness, and disability in heavy object lifting, light object lifting and reaching overhead were significantly lower than those of the RND group.In FND, one aims to preserve anatomically the spinal accessory nerve, and it is presumed to be intact after the procedure. However, using EMG nerve function monitoring, our study revealed that profound spinal nerve injury was detected immediately after FND surgery, which tended to improve over subsequent months but had not regained its original function by the end of the ninth post-operative month.


2001 ◽  
Vol 26 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Z. H. DAILIANA ◽  
H. MEHDIAN ◽  
A. GILBERT

The course of spinal accessory nerve in the posterior triangle, the innervation of the sternocleidomastoid and trapezius muscles and the contributions from the cervical plexus were studied in 20 cadaveric dissections. The nerve was most vulnerable to iatrogenic injuries after leaving the sternocleidomastoid. Direct innervation of trapezius by cervical plexus branches was noted in five dissections, whereas connections between the cervical plexus and the spinal accessory nerve were observed in 19 dissections. These were usually under the sternocleidomastoid (proximal to the level of division of the nerve in nerve transfer procedures). Although the contribution from the cervical plexus to trapezius innervation is considered minimal, trapezius function can be protected in neurotization procedures by transecting the spinal accessory nerve distal to its branches to the upper position of trapezius.


1975 ◽  
Vol 84 (6) ◽  
pp. 812-816 ◽  
Author(s):  
W. H. Saunders ◽  
E. W. Johnson

After classical radical neck dissection with removal of the sternocleidomastoid muscle and division of the spinal accessory nerve, there are certain disabling or disagreeable musculoskeletal defects. This paper describes the muscular deficiencies and gives a set of exercises which can be counted on to minimize the problems.


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