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Structured Motor Rehabilitation After Selective Nerve Transfers
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[Post-operative functional evaluation of accessory nerve reconstruction].

Koji Asakura1, Tomo Honma1, Takashi Keira2

  • 1Department of Otorhinolaryngology, Muroran City General Hospital, Muroran.

Nihon Jibiinkoka Gakkai Kaiho
|March 8, 2014
PubMed
Summary

Spinal accessory nerve reconstruction improved shoulder function after neck dissection. Both direct nerve repair and grafting to cervical nerves yielded better outcomes than no reconstruction, though not as good as nerve preservation.

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Area of Science:

  • Neurosurgery
  • Reconstructive Surgery
  • Oncology

Context:

  • Total neck dissection for cancer frequently necessitates resection of the spinal accessory nerve.
  • This can lead to significant shoulder dysfunction and impact patient quality of life.

Purpose:

  • To evaluate the functional outcomes of different spinal accessory nerve reconstruction techniques following total neck dissection.

Summary:

  • Twenty patients underwent spinal accessory nerve reconstruction after resection during total neck dissection.
  • Fourteen patients had direct re-anastomosis or cable grafting of the accessory nerve (accessory nerve reconstruction group).
  • Six patients underwent grafting between the accessory nerve and cervical nerves (C2 or C3) (cervical/accessory nerve reconstruction group).
  • Postoperative shoulder function was assessed and compared between groups, including a control group (n=13) without reconstruction and a nerve preservation group (n=41).

Impact:

  • Both accessory nerve reconstruction methods demonstrated significantly better shoulder function compared to no reconstruction.
  • Outcomes, while improved, tended to be inferior to those achieved with nerve preservation.
  • These findings support reconstructive strategies to mitigate functional deficits after essential nerve resection in head and neck cancer surgery.