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[Preserving the accessory nerve in neck dissection].

A Berghaus1, S Holtmann, J von Scheel

  • 1HNO-Klinik, Klinikum Steglitz der Freien Universität Berlin.

HNO
|February 1, 1988
PubMed
Summary
This summary is machine-generated.

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Preserving the accessory nerve (eleventh cranial nerve) during neck dissection significantly reduces shoulder dysfunction and strength loss. This finding impacts surgical techniques and patient recovery after neck surgery.

Area of Science:

  • Neurosurgery
  • Orthopedics
  • Oncology

Context:

  • Neck dissection is a common surgical procedure for head and neck cancers.
  • Shoulder dysfunction is a frequent complication following neck dissection.
  • The accessory nerve (cranial nerve XI) is vulnerable during this surgery.

Purpose:

  • To evaluate the impact of accessory nerve preservation versus severance on shoulder function after neck dissection.
  • To quantify the loss of shoulder strength and correlate it with patient-reported outcomes.
  • To explore potential trade-offs between nerve preservation and oncological outcomes.

Summary:

  • A study of 104 patients found significantly less shoulder strength loss when the accessory nerve was preserved compared to when it was severed during neck dissection.

Related Experiment Videos

  • Functional loss correlated well with patients' subjective experiences of impairment.
  • Tumor stage and postoperative irradiation did not significantly influence functional loss.

    • Impact:

    • Highlights the importance of accessory nerve preservation for maintaining shoulder function post-neck dissection.
    • Suggests that surgical techniques prioritizing nerve integrity can improve patient quality of life.
    • Raises questions about the oncological safety of accessory nerve preservation, particularly regarding lymph node recurrence risk.