[How important is preservation of the accessory nerve in neck dissection?]

Preservation of the spinal accessory nerve in radical or modified neck dissection is oncologically accepted in order to avoid the sequelae of the so called "shoulder syndrome". In 23 patients, on whom 29 neck dissections had been performed, the functional results were evaluated on an average 2.6 years postoperatively. 19 patients were radiated post surgery. Clinical and electromyographic examination revealed paresis of 62% of the preserved accessory nerves. Nevertheless, only 48% of the patients suffered from the shoulder syndrome, the remaining were able to innervate or compensate for the resulting deficit. Postoperative functional exercises are mandatory to prevent the shoulder syndrome and to make the preservation technique a worthwhile concept.