Identification of the Spinal Accessory Nerve Within the Surgical Field During Primary Exploration of the Brachial Plexus in Infants With Obstetric Palsy

Al‐Qattan, Mohammad M.; El-Shayeb, A.

doi:10.1016/j.jhsa.2005.02.003

Cited by 10 publications

(7 citation statements)

References 9 publications

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“…It has also been described at surgery [26,27]. Symes and Ellis [11] reported 1-5 branches to trapezius arising in 84% of nerves in the posterior triangle, whereas we observed branching in 54% (50 of 92) of nerves at this site.…”

Section: Discussionsupporting

confidence: 65%

Ultrasound Visualization of the Spinal Accessory Nerve In Vivo

Mirjalili

Muirhead

Stringer

2012

Journal of Surgical Research

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Section: Discussionsupporting

confidence: 65%

Ultrasound Visualization of the Spinal Accessory Nerve In Vivo

Mirjalili

Muirhead

Stringer

2012

Journal of Surgical Research

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“…This branch enters the descending portion of the muscle approximately 2–3 cm cranial to the point at which the main trunk enters the muscle 27C , 28C , 38C . It has been noted intra-operatively by a number of authors, particularly in the plastic surgical literature 28C , 39L , 40L . Electromyographic work by Kierner et al on patients undergoing neck dissection has confirmed that this branch is the main motor supply to the descending portion of the muscle, whilst the transverse and ascending portions are supplied by the main trunk of the spinal accessory nerve 41L .…”

Section: Anatomymentioning

confidence: 98%

Accessory nerve: anatomy and surgical identification

Lloyd

2007

J. Laryngol. Otol.

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The XIth cranial nerve or accessory nerve provides the motor supply to the sternocleidomastoid and trapezius muscles. It is frequently encountered during neck surgery, and as such is at risk of iatrogenic injury, resulting in the 'shoulder syndrome'. Historically, the nerve was sacrificed on oncological grounds during radical neck dissection. However, the basis for sacrifice is unfounded in the majority of cases, and accessory nerve sparing selective neck dissection has equal oncological efficacy. The path of the nerve in the neck is very variable, and there is not a wholly reliable landmark for its identification. However, there are a number of methods described in the literature to guide the surgeon in its identification. This paper provides a systematic review of all the methods available for identification of the accessory nerve, and comments on the reliability of each. In doing so, the detailed anatomy of the accessory nerve is also described.

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“…19 Cruza la vena yugular interna 20 y, en el 80% de los casos, perfora al esternocleidomastoideo; en el 20% restante, discurre posterior a este. 21 Luego, desciende oblicuamente entre la fascia superficial y profunda del cuello en íntima relación con los ganglios linfáticos cervicales.…”

Section: Discussionunclassified

Parálisis obstétrica del plexo braquial: resultados preliminares de la transferencia del nervio espinal accesorio al nervio supraescapular en 10 casos. [Accessory nerve to suprascapular nerve transfer in obstetrical brachial plexus palsy: preliminary results in 10 cases.]

Valbuena¹

2015

Rev. Asoc. Arg. Ort. y Traumatol

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113 ResumenObjetivo: Evaluar los resultados preliminares en 10 casos de transferencias del nervio espinal accesorio al nervio supraescapular en parálisis obstétricas del plexo braquial. Materiales y Métodos: Entre 2010 y 2012, se realizaron 16 transferencias del nervio espinal accesorio al nervio supraescapular en parálisis obstétricas del plexo braquial. Se incluyeron 10 casos con un seguimiento mínimo de 18 meses. Se evaluó la fuerza muscular del hombro según la escala de Gilbert y se usaron escalas funcionales de Mallet y de Gilbert. Se compararon valores preoperatorios y posoperatorios, así como las diferencias entre parálisis de tipo parcial y total. Se usó la prueba de Student para valorar la significancia estadística de los datos. Resultados: El seguimiento promedio fue de 20.9 meses. Se hallaron valores medios preoperatorios de fuerza de abducción de 0,48 M, y posoperatorios de 2,70 M; los valores de rotación externa preoperatorios fueron de 0 M y, al final del seguimiento, de 2,4 M. Todos los pacientes mostraban patrones preoperatorios de tipo 1 tanto de la escala de Mallet como la de Gilbert, con valores posoperatorios promedio de 3,2 y 3,5, respectivamente. Se hallaron diferencias estadísticamente significativas entre estos valores. Conclusiones: Esta serie presenta valores preliminares con un seguimiento corto y su principal crítica es el bajo número de casos. Los resultados funcionales obtenidos coinciden con los de otros reportes, y avalan su uso en las reconstrucciones del plexo braquial que requieran aporte extraplexual. were assessed according to the Gilbert scale, and functional scales of the shoulder (Mallet and Gilbert) were used. Preoperative and postoperative values, and the differences between partial and total paralysis results were compared. Student test was used for the statistical analysis. Results:The average follow-up was 20.9 months. Preoperative shoulder abduction power was 0.48 M, preoperative external rotation power was 0 M, and those values at the end of the follow-up were 2.70 M and 2.4 M, respectively. All patients had type 1 patterns of the Gilbert and Mallet scales, with mean postoperative values of 3.2 and 3.5, respectively. Statistically significant differences were found between these values. Conclusions: Limitations of this preliminary report are the short follow-up and the low number of cases. However, the functional results obtained are consistent with those from other reports, and they support the use of the spinal accessory nerve to suprascapular nerve transfer in brachial plexus reconstructions requiring an extra-plexual contribution.

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Identification of the Spinal Accessory Nerve Within the Surgical Field During Primary Exploration of the Brachial Plexus in Infants With Obstetric Palsy

Cited by 10 publications

References 9 publications

Ultrasound Visualization of the Spinal Accessory Nerve In Vivo

Ultrasound Visualization of the Spinal Accessory Nerve In Vivo

Accessory nerve: anatomy and surgical identification

Parálisis obstétrica del plexo braquial: resultados preliminares de la transferencia del nervio espinal accesorio al nervio supraescapular en 10 casos. [Accessory nerve to suprascapular nerve transfer in obstetrical brachial plexus palsy: preliminary results in 10 cases.]

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