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Muscles of the Anterior Neck01:26

Muscles of the Anterior Neck

The anterior neck muscles are the group of muscles covering the front part of the neck. These muscles are classified into three subgroups. The first one is the superficial muscles, the most visible muscles in the front of the neck. It includes the platysma and sternocleidomastoid. The second group is the suprahyoid muscles, located above the hyoid bone. This group comprises the digastric, mylohyoid, geniohyoid, and stylohyoid. Lastly, the infrahyoid muscles are found below the hyoid bone and...

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Modified Radical Neck Dissection for Cervical Metastasis
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Electromyographic findings after different selective neck dissections.

Tetsuya Tsuji1, Akira Tanuma, Tetsuro Onitsuka

  • 1Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. cxa01423@nifty.com

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|January 6, 2007
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Summary

Selective neck dissection (SND) can cause upper trapezius muscle (UT) denervation due to nerve injury. Preserving cervical nerves (C2-4) is crucial to minimize UT damage after SND.

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Area of Science:

  • Neurosurgery
  • Electromyography
  • Muscle Physiology

Background:

  • Selective neck dissection (SND) is a surgical procedure for head and neck cancers.
  • Upper trapezius muscle (UT) function can be affected by SND.
  • Electrophysiologic investigations can assess muscle denervation.

Purpose of the Study:

  • To compare electromyography (EMG) findings of the UT after different types of SND.
  • To analyze the impact of preserving or excising cervical nerves (C2-4) on UT function.

Main Methods:

  • Retrospective study of 54 patients undergoing 70 SND procedures.
  • Needle electromyography (EMG) of the UT was performed within 4 months post-surgery.
  • EMG findings were scored using a 5-point scale (1=total denervation, 5=normal).

Main Results:

  • The average EMG score indicated significant UT denervation (1.7 +/- 1.1), with 58.6% scoring 1.
  • No significant difference in EMG scores between different SND types.
  • Excision of cervical nerves resulted in significantly worse UT denervation compared to preservation (average scores 1.5 vs. 2.0).

Conclusions:

  • Complete or incomplete UT denervation after SND is often due to axonal injury of the spinal accessory nerve, even if spared.
  • Excision of C2-4 cervical nerves leads to worse UT damage.
  • Preserving cervical nerves is important to prevent UT denervation.