The spinal accessory nerve in head and neck surgery

Cappiello, Johnny; Piazza, Cesare; Nicolai, Piero

doi:10.1097/moo.0b013e3280523ac5

Cited by 64 publications

(50 citation statements)

References 38 publications

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“…These findings are in agreement with those from our study 15 . We have noticed that Snd causes better shoulder function when compared to other types of dissections; this difference has been explained by less level V manipulation during the surgical procedure, resulting in less damage to the accessory nerve and the neck plexus 1,7,[12][13][14]17,18 . The shoulder syndrome is an important sequela of nd.…”

Section: Discussionmentioning

confidence: 99%

“…When properly planned, more conservative procedures such as the Mrnd and the Snd respect the principles of oncologic radicalism, besides having the additional advantage of minimizing the functional deficiencies resulting from rnd and Bnd. The most relevant functional aspect is, without doubts, the involvement of shoulder function arising from damage to the Xi cranial nerve with consequent trapezium muscle denervation 7 . The anatomical characteristics of the spinal accessory nerve explain why surgical procedures in the neck, especially those done in the posterior triangle, frequently cause paralysis to this nerve 3 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Spinal accessory nerve neuropathy following neck dissection

Lima¹,

Amar²,

Lehn³

2011

Braz. j. otorhinolaryngol. (Impr.)

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Tt he most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle.Aim: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection.Materials and methods: prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. nerve integrity was evaluated before and after the surgery by means of surface eMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/ atrophy of the trapezius muscle.Results: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (p<0.001). There was a mean decrease of 70% comparing to preoperative values. The median was 12.5 microV after dissection including level iib, and 8.9 microV after dissection including levels iib and V (p<0.002). Conclusion:Surface eMG is a sensitive and painless method for spinal accessory nerve dysfunction evaluation. The results suggest the usefulness of the trapezius muscle electromyography to confirm diagnosis and early physical therapy intervention in neuropathies of the spinal accessory nerve. Braz J Otorhinolaryngol. 2011;77(2):259-62. ORIgInAL ARTIcLE BJORL

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Spinal accessory nerve neuropathy following neck dissection

Lima¹,

Amar²,

Lehn³

2011

Braz. j. otorhinolaryngol. (Impr.)

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“…[15][16][17] and the effect of protecting accessory nerves on shoulder functions. 1,[18][19][20][21] However, best of our knowledge, there was no study assessed the correlation between voice quality and QOL in patients with larynx cancer. In our study we evaluated QOL in larynx cancer patients according to treatment type, surgery type, administration of RT and voice changes.…”

Section: Quality Of Life Analysismentioning

confidence: 99%

Larenks kanserli hastalarda adjuvant radyoterapinin ses ve yaşam kalitesi ile ilişkisi

Kara¹,

Ertekin²,

Şahin³

et al. 2017

Aile Hekimliği Ve Palyatif Bakım

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Introduction: To evaluate the effect of surgery type and adjuvant radiotherapy (RT) on voice quality and quality of life in patients with larynx cancer. Methods: 38 patients with larynx cancer (37 males, 1 female; mean age 63.6 ± 9.63 years) were included in this study. The parameters including tumor localization, TNM staging, and type of surgery performed, adjuvant/primary RT intake and recurrence were recorded. All participants filled voice handicap index (VHI-10) and University of Washington Quality of Life Questionnaire version-IV (UWQOL-4). Voice analysis was performed by Xion Endo Strop-DX system. Questionnaire scores and voice parameters were compared between groups. Results: There was a statistically significant low mean values of VHI detected within the group of stripping/cordectomy compared to groups of partial or total laryngectomy. In the group without RT, the mean values of SPLmin, MPT, pain, appearance, swallowing and chewing subgroups of UWQOL scale were higher than the group treated with RT. There was a negative correlation identified between VHI and QOL parameters. Conclusion: In advanced stage larynx cancer, increased surgical manipulation and adjuvant RT requirements decrease QOL. As a result early diagnosis of disease and treatment is very important. As subjective voice quality increases QOL scores rise, indicating the importance of referring patients for voice therapy and psychotherapy after treatment.

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“…Chronic complications include shoulder pain/dysfunction, neck stiffness, edema, trismus, etc. Loss of motor innervation to the sternocleidomastoid and Trapezius, results in loss of mobility and strength of the shoulder leading into reduced cervical range of motion [3]. Skin complications include cervical contracture, pain, thickening and edema of tissue (lymphedema).…”

Section: Review On Head and Neck Cancersmentioning

confidence: 99%