A technique to identify and preserve the spinal accessory nerve during neck dissection

Chaukar, Devendra; Pai, Ameya; D'Cruz, Anil

doi:10.1017/s0022215106000879

Cited by 20 publications

(24 citation statements)

References 5 publications

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“…Most describe preservation of SAN through its identification in the lower neck, near its entry at the anterior border of the trapezius muscle. 5 A lesser number of studies are available in literature describing the courses of SAN in relation to its surrounding structures in the upper neck region. 3,4,8 Different authors have reported variable relations of SAN with IJV in upper neck and most of these studies report a higher incidence of lateral relation of SAN to IJV compared with a medial relation.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,8 Different authors have reported variable relations of SAN with IJV in upper neck and most of these studies report a higher incidence of lateral relation of SAN to IJV compared with a medial relation. [3][4][5][7][8][9] There is a lot of variation in the incidence of lateral and medial relation in different studies with some reporting a very low percentage of medial relation. 3 Also there is variability in the results of cadaveric studies and those on live ND.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

Dhawan¹,

Duggal²,

Sandhu³

2012

International Journal of Head and Neck Surgery

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A patient with squamous cell carcinoma of right retromolar area of the mandible and undergoing a staging neck dissection was noted to have a unique relationship of the internal jugular vein and spinal accessory nerve. At the upper end of the dissection (level II, Memorial Sloan-Kettering classification), the spinal accessory nerve was observed to pass directly through the internal jugular vein. Although previously described only once in the literature, this finding may be encountered by other surgeons who operate in this area and it is important that these anatomical variations are borne in mind to prevent inadvertent injury. To our knowledge, this must be the first case reported from India.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

Dhawan¹,

Duggal²,

Sandhu³

2012

International Journal of Head and Neck Surgery

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show abstract

“…3,4,8 Different authors have reported variable relations of SAN with IJV in upper neck, and most of these studies report a higher incidence of lateral relation of SAN to IJV compared to a medial relation. [3][4][5][7][8][9] There is a lot of variation in the incidence of lateral and medial relation in different studies with some reporting a very low percentage of medial relation. 3 Also there is variability in the results of cadaveric studies and those on live ND.…”

Section: Discussionmentioning

confidence: 99%

A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

Duggal¹,

Dhawan²,

Sandhu³

2011

International Journal of Head and Neck Surgery

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A patient with a squamous cell carcinoma of right retromolar area of the mandible and undergoing a staging neck dissection was noted to have a unique relationship of the internal jugular vein and spinal accessory nerve. At the upper end of the dissection (level II, Memorial Sloan-Kettering classification), the spinal accessory nerve was observed to pass directly through the internal jugular vein. Although previously described only once in the literature, this finding may be encountered by other surgeons who operate in this area and it is important that these anatomical variations are borne in mind to prevent inadvertent injury. To our knowledge, this must be the first case reported from India.

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“…The clinical significance of recognizing the position of the accessory nerve as it enters the lateral cervical region just superior to the nerve point of the neck is that its preservation in modified radical neck dissection, as might be performed to resect metastatic tumors or cervical lymph nodes, helps minimize subsequent shoulder dysfunction (Robbins and Samant, 2005;Chaukar et al, 2006;Salgarelli et al, 2009). It is also Nerve point of the neck and its relationship to the SCM muscle.…”

Section: Clinical Relevancementioning

confidence: 99%

“…Sections of the anterior scalene muscle, common carotid artery, and internal jugular vein were removed to expose the phrenic and vagus nerves. lateral cervical region) has been referred to as Erb's point (Robbins and Samant, 2005;Chaukar et al, 2006;Salgarelli et al, 2009). It is important, however, to appreciate that this is not the original intent of the term (Tubbs et al, 2007).…”

Section: Erb's Point-its Uses and Misusesmentioning

confidence: 99%

A modified dissection method to preserve neck structures

Hankin

Stoller

2009

Anatomical Sciences Ed

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The neck is not only one of the more challenging anatomical regions to dissect but also has important application to clinical conditions, diseases, and procedures. In this study, we describe two simple modifications for dissection of the neck that (1) aid in the identification and preservation of the cutaneous branches of the cervical plexus and the accessory nerve, and (2) provide wide exposure of the root of the neck. The cutaneous branches of the cervical plexus can be identified with relative ease at the nerve point of the neck, where they are largest. To accomplish this, the skin and platysma are reflected beginning from the anterior border of trapezius and proceeding anteriorly to the midline of the neck, rather than the conventional approach of reflecting the skin from the anterior midline. The accessory nerve is identified by its relationship to the nerve point and its course to the trapezius muscle. To achieve wide exposure of the root of the neck and its contents, the acromioclavicular and sternoclavicular joints are disarticulated, and then the clavicle removed completely, rather than the more common approach of removing only the middle section of the clavicle. These modified procedures can be readily performed by first-year medical students and integrate well with methods described in widely used anatomy dissection manuals.

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A technique to identify and preserve the spinal accessory nerve during neck dissection

Abstract: Our method enables the surgeon to locate the nerve precisely and to avoid damage to it, thereby maximizing post-operative function.

Cited by 20 publications

References 5 publications

A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein

A modified dissection method to preserve neck structures

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