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Electrophysiologic analysis of injury to cranial nerve XI during neck dissection
Bostjan Lanisnik1, Miha Zargi2, Zoran Rodi3
1Department of ENT-Head and Neck Surgery, University Medical Center, Maribor, Slovenia.
Background:
Despite preservation of the accessory nerve, a considerable number of patients report partial nerve damage after modified radical neck dissection (MRND) and selective neck dissection.
Methods:
Accessory nerve branches for the trapezius muscle were stimulated during neck dissection, and the M wave amplitude was measured during distinct surgical phases.
Results:
The accessory nerve was mapped in 20 patients. The M wave recordings indicated that major nerve damage occurred during dissection at levels IIa and IIb in the most proximal segment of the nerve. The M waves evoked from this nerve segment decreased significantly during surgery (analysis of variance; p = .001).
Conclusion:
The most significant intraoperative injury to the accessory nerve during neck dissection occurs at anatomic nerve levels IIa and IIb. © 2015 Wiley Periodicals, Inc. Head Neck 38: E372-E376, 2016.
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