Upper neck spinal accessory nerve identification during neck dissection.
نویسندگان
چکیده
Iatrogenic injury to the spinal accessory nerve (SAN) during neck dissection may result in significant and avoidable morbidity in the form of 'shoulder syndrome'. The authors describe a simple method, based on the anatomy of the sternocleidomastoid muscle (SCM), which allows consistent and rapid identification of the SAN in the upper neck during dissection, thereby facilitating its preservation.
منابع مشابه
Cable grafting of the spinal accessory nerve after radical neck dissection.
BACKGROUND From January 1981 through March 1996, 20 patients with head and neck cancer underwent radical neck dissection with sacrifice of the spinal accessory nerve and immediate reconstruction of the nerve using a microsurgical technique and a cable graft of the great auricular nerve. METHODS Postoperative shoulder function was assessed via a subjective questionnaire, objective strength tes...
متن کاملSpinal accessory nerve injury after rhytidectomy (face lift): a case report.
Injury to the spinal accessory nerve can be a disabling disorder. Patients with a spinal accessory nerve injury may have pain, paresthesias, and motor weakness that may result in scapular winging. The nerve can be injured by open, penetrating, or closed trauma; however, the most common cause is iatrogenic. This is most commonly encountered after procedures in the posterior triangle of the neck ...
متن کاملMinimizing shoulder syndrome with intra-operative spinal accessory nerve monitoring for neck dissection
The objective of this study was to analyze the safety and results of intra-operative SAN (spinal accessary nerve) monitoring during selective neck dissection, with emphasis on shoulder syndrome. Twenty-five consecutive patients with head and neck cancer were studied. Selective neck dissection was performed by a single clinical fellow under the supervision of the department chief using an intra-...
متن کاملSpinal accessory nerve preservation in modified neck dissections: surgical and functional outcomes
The spinal accessory nerve (SAN) or XI cranial nerve is frequently encountered during neck surgery, and as such is at risk of iatrogenic injury, resulting in "shoulder syndrome". Modified neck dissection (MND) with preservation of the SAN is based on desire to minimise the functional deformity associated with section of the eleventh nerve. The aim of this study was to analyse the intra-operativ...
متن کاملIdentification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping
BACKGROUND In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND). METHODS The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor. RESULTS The accessory nerve was mapped during 74 hemineck dissections and three patterns...
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ورودعنوان ژورنال:
- The Journal of laryngology and otology
دوره 119 11 شماره
صفحات -
تاریخ انتشار 2005