An anomaly in the nerve supply of the trapezius muscle

Stacey, R; O’Leary, S.; Hamlyn, Peter J.

doi:10.1002/(sici)1098-2353(1996)9:6<414::aid-ca11>3.0.co;2-u

Cited by 23 publications

(10 citation statements)

References 3 publications

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“…Connections and considerable variations have been reported in the anatomy of the glossopharyngeal, vagus and accessory nerves rostral to the jugular foramen, within the foramen and caudal to the foramen (Sachs & Valtin, 1977;Hollinshead, 1982;Stacey et al, 1996;Brown et al, 2000;Gardiner et al, 2002;Bergman & Afifi, 2004). The course and peripheral distribution of CN X and CN XI in the neck have been reported extensively (Romanes, 1979;Hollinshead, 1982;Soo et al, 1986Soo et al, , 1990Krause et al, 1991;Standring, 2005).…”

confidence: 99%

Is the cranial accessory nerve really a portion of the accessory nerve? Anatomy of the cranial nerves in the jugular foramen

et al. 2007

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The accessory nerve is traditionally described as having both spinal and cranial roots, with the spinal root originating from the upper cervical segments of the spinal cord and the cranial root originating from the dorsolateral surface of the medulla oblongata. The spinal rootlets and cranial rootlets converge either before entering the jugular foramen or within it. In a recent report, this conventional view has been challenged by finding no cranial contribution to the accessory nerve. The present study was undertaken to re-examine the accessory and vagus nerves within the cranium and jugular foramen, with particular emphasis on the components of the accessory nerve. These nerves were traced from their rootlets attaching to the spinal cord and the medulla and then through the jugular foramen. The jugular foramen was exposed by removing the dural covering and surrounding bone. A surgical dissecting microscope was used to trace the roots of the glossopharyngeal nerve (CN IX), vagus nerve (CN X) and accessory nerve (CN XI) before they entered the jugular foramen and during their travel through it. The present study demonstrates that the accessory nerve exists in two forms within the cranial cavity. In the majority of cases (11 of 12), CN XI originated from the spinal cord with no distinct contribution from the medulla. However, in one of 12 cases, a small but distinct connection was seen between the vagus and the spinal accessory nerves within the jugular foramen.

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confidence: 99%

Is the cranial accessory nerve really a portion of the accessory nerve? Anatomy of the cranial nerves in the jugular foramen

et al. 2007

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“…Shoulder abduction is reduced to a variable extent in patients with XIth nerve palsy, probably because there is some variability in the innervation of the trapezius. 3,[5][6][7] Injury to other motor nerves during surgery has been reduced with monitoring techniques. [8][9][10] In ENT and head and neck surgery there has been increasing recognition of the value of monitoring of the facial nerve in parotid and middle-ear surgery.…”

Section: Introductionmentioning

confidence: 99%

Accessory nerve monitoring and stimulation during neck surgery

Midwinter

Willatt

2002

J. Laryngol. Otol.

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Iatrogenic injury to the spinal accessory nerve following surgical procdures in the neck is well recognized in causing significant morbidity to patients, with shoulder pain and loss of function being particularly problematic. We have used a Magstim Neurosign 100 peripheral nerve monitor, that is most often used in our practice to monitor the facial nerve during middle ear and parotid surgery, to monitor the accessory nerve during neck surgery. Ten patients undergoing accessory nerve-sparing neck dissection, or excision biopsy of neck mass had their accessory nerve monitored during the procedure. No patient suffered injury of the nerve. In several cases the nerve closely adhered to the tissue being resected, and in two cases, the nerve bifurcated or gave off branches. We found that the monitor aided identification and preservation of the nerve.

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“…6 There are variations in the motor and sensory innervations of the trapezius and the sternocleidomastoid muscles. 7 There are case reports in which the innervation comes entirely from the cervical plexus. 7,8 Additionally, there are reports that the trapezius muscle receives a partial motor supply from thoracic roots.…”

Section: Discussionmentioning

confidence: 99%

“…7 There are case reports in which the innervation comes entirely from the cervical plexus. 7,8 Additionally, there are reports that the trapezius muscle receives a partial motor supply from thoracic roots. 1 The standard radical neck dissection for head and neck tumors involves the removal of lymphatic tissues, the internal jugular vein, the sternocleidomastoid muscle and the accessory nerve.…”

Section: Discussionmentioning

confidence: 99%