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Upper neck spinal accessory nerve identification during neck dissection.

T Tatla¹, J Kanagalingam, A Majithia

¹Department of Otorhinolaryngology-Head & Neck Surgery, Charing Cross Hospital, London, UK. tarantatla@hotmail.com

The Journal of Laryngology and Otology

|December 16, 2005

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Iatrogenic injury to the spinal accessory nerve (SAN) during neck dissection can cause shoulder syndrome. This study presents a simple anatomical method using the sternocleidomastoid muscle (SCM) to identify and preserve the SAN during surgery.

Area of Science:

Surgical anatomy
Neurosurgery
Head and neck surgery

Background:

Iatrogenic injury to the spinal accessory nerve (SAN) during neck dissection is a common cause of significant morbidity.
This nerve injury can lead to 'shoulder syndrome,' characterized by pain and dysfunction.
Preservation of the SAN is crucial for maintaining shoulder function after neck surgery.

Purpose of the Study:

To describe a simple, reliable method for identifying the spinal accessory nerve (SAN) during neck dissection.
To facilitate the preservation of the SAN and reduce the incidence of shoulder syndrome.
To utilize the anatomical landmarks of the sternocleidomastoid muscle (SCM) for consistent SAN identification.

Main Methods:

The study describes a surgical technique based on the detailed anatomy of the sternocleidomastoid muscle (SCM).

Related Experiment Videos

The method focuses on the upper portion of the neck during the dissection process.

Emphasis is placed on consistent and rapid identification of the SAN.

Main Results:

The described method allows for consistent and rapid identification of the SAN in the upper neck.
This anatomical approach aids in the preservation of the spinal accessory nerve during neck dissection.
The technique aims to minimize iatrogenic injury and subsequent patient morbidity.

Conclusions:

A straightforward anatomical method using the SCM muscle can reliably identify the SAN during neck dissection.
This technique facilitates SAN preservation, thereby preventing or reducing shoulder syndrome.
The described approach offers a practical solution for improving surgical outcomes in head and neck procedures.