Spinal Accessory Nerve Function following Neck Dissection

Abstract

Spinal accessory nerve (SAN) function was evaluated by electromyography (EMG) and muscle testing in 36 patients who underwent neck dissection with SAN preservation. The results emphasized that SAN function was relatively good after conservative neck surgery. Muscle testing findings showed better function than did EMC findings. After surgery the trapezius muscle functioned more efficiently than the sternocleidomastoid (SCM) muscle probably because of the more traumatic surgical handling of both the SCM muscle and its SAN branch. In order to obtain the functional advantages of SAN preservation, the authors suggest that the conservative procedure in radical neck dissection be used whenever warranted by oncologic diagnosis.

Keywords

accessory nerve electromyography head and neck neoplasms neck surgery

Get full access to this article

View all access options for this article.

References

Suarez

El problema de las metastasis linfaticas y aleiadas del cancer de laringe e hipofaringe. Rev Otorinolaryngol 1963; 23: 83–99

Bocca

Supraglottic laryngectomy and functional neck dissection. J Laryngol Otol 1966; 80: 831–8

Bocca

Pignataro

A conservation technique in radical neck dissection. Ann Otol Rhinol Laryngol 1967; 76: 975–87

Bocca

Conservative neck dissection. Laryngoscope 1975; 85: 1511–5

Bocca

Pignataro

Sasaki

. Functional neck dissection. Arch Otolaryngol 1980; 106: 524–7

Lingeman

Helmus

Stephens

Ulm

Neck dissection: Radical or conservative. Ann Otol Rhinol Laryngol 1977; 86: 737–44

Nahum

Mullally

Marmor

A syndrome resulting from radical neck dissection. Arch Otolaryngol 1961; 74: 424–8

Becker

Parell

. Technique of preserving the spinal accessory nerve during radical neck dissection. Laryngoscope 1979; 89: 827–31

Brandenburg

Lee

CYS

. The eleventh nerve in radical neck surgery. Laryngoscope 1981; 91: 1851–9

10.

Skolnik

Tenta

Wineinger

Tardy

. Preservation of XI cranial nerve in neck dissections. Laryngoscope 1967; 77: 1304–14

11.

Skolnik

Deutsch

. Conservative neck dissection. J Laryngol Otol [Suppl] 1983(suppl 8): 105

12.

Stearns

Shaheen

. Preservation of the accessory nerve in block dissection of the neck. J Laryngol Otol 1981; 95: 1141–8

13.

Shumrick

. Neck dissection. In: Paparella

Shumrick

, eds. Otolaryngology. Philadelphia: WB Saunders, 1980: 2972–7

14.

Daniels

Williams

Worthingam

Muscle testing. Philadelphia: WB Saunders, 1947

15.

Cherrington

Accessory nerve. Conduction studies. Arch Neurol 1968; 18: 708–9

16.

Carenfelt

Eliasson

Radical neck dissection and permanent sequelae associated with spinal accessory nerve injuries. Acta Otolaryngol (Stockh) 1981; 91: 155–60

17.

Saunders

Johnson

. Rehabilitation of the shoulder after radical neck dissection. Ann Otol Rhinol Laryngol 1975; 84: 812–6

18.

Valtonen

Lilius

. Late sequelae of iatrogenic spinal accessory nerve injury. Acta Chir Scand 1974; 140: 453–5

19.

Bagatella

Aiello

Bignardi

Rosati

Il destino del nervo spinale dopo lo svuotamento funzionale del collo. Nuovo Arch Ital Otol 1978; 6: 741–52

20.

Fiorella

Ferrannini

Cervallera

Valutazione dell'attivita‘ dello SCM dopo svuotamento laterocervicale secondo Bocca. Nuovo Arch Ital Otol 1977; 4: 769–76

21.

Rognoni

Baiocco

Savare

La pervieta‘ della vena giugulare interna dopo svuotamento laterocervicale funzionale: Verifica mediante velocimetria Doppler. Acta Otorhinolaryngol Ital 1983; 3: 167–73