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Quantification of Trapezius Muscle Innervation During Neck Dissections: Cervical Plexus Versus the Spinal Accessory
Clara Svenberg Lind1, Bertil Lundberg2, Lalle Hammarstedt Nordenvall2
1Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden clara.svenberg-lind@karolinska.se.
The Annals of Otology, Rhinology, and Laryngology
|June 3, 2015
Summary
Cervical plexus branches significantly innervate the trapezius muscle, alongside the spinal accessory nerve (SAN). Intraoperative monitoring can identify these crucial SAN-alternative pathways during neck dissections.
Area of Science:
- Anatomy
- Neurosurgery
- Peripheral Nervous System
Background:
- Selective nerve-sparing techniques in neck dissections have not reduced trapezius muscle paralysis rates.
- Understanding trapezius muscle innervation is crucial for preventing postoperative dysfunction.
Purpose of the Study:
- To quantify and compare motor inflow to the trapezius muscle.
- To elucidate the peripheral neuroanatomy of the trapezius muscle.
Main Methods:
- Intraoperative nerve monitoring (electroneurography) was performed on 18 patients undergoing neck dissection.
- Compound muscle action potentials were used to map and quantify innervation to the three functional parts of the trapezius muscle.
Main Results:
- The spinal accessory nerve (SAN) innervated all parts of the trapezius in 100% of patients.
- An additional motor branch from the cervical plexus innervating the trapezius was detected in 39% of patients.
Conclusions:
- Cervical plexus branches provide substantial neural input to the trapezius, comparable to the SAN.
- Intraoperative monitoring can identify these cervical plexus branches, offering potential protection against SAN injury during neck dissections.
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