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Related Experiment Videos

Considering the spinal accessory nerve in head and neck surgery.

J R Saunders, R M Hirata, D A Jaques

    American Journal of Surgery
    |October 1, 1985
    PubMed
    Summary

    Radical neck dissection often impacts trapezius muscle function. Surprisingly, many patients with spinal accessory nerve sacrifice reported few trapezius deficits, while nerve preservation did not guarantee full muscle function.

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    Area of Science:

    • Head and Neck Surgery
    • Reconstructive Surgery
    • Oncology

    Background:

    • Trapezius muscle dysfunction is a significant long-term complication following radical neck dissection.
    • Preservation of the trapezius muscle is a key goal in modified neck dissection techniques.

    Purpose of the Study:

    • To evaluate trapezius muscle function in patients after various radical neck dissection techniques.
    • To assess the functional outcomes related to spinal accessory nerve management during neck dissection.

    Main Methods:

    • A retrospective evaluation of 100 patients who underwent composite resection for head and neck cancer.
    • Assessment of trapezius muscle function and symptoms at a mean of 6.2 years post-surgery.
    • Comparison of outcomes following radical neck dissection with spinal accessory nerve sacrifice, preservation, or cable graft reconstruction.

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    Main Results:

    • 67% of patients with spinal accessory nerve sacrifice had minimal trapezius-related symptoms despite significant muscle atrophy.
    • 20% of patients with spinal accessory nerve preservation exhibited poor trapezius muscle function.
    • Interpositioned nerve grafts were functional in 66% of patients.

    Conclusions:

    • A substantial number of patients undergoing radical neck dissection with spinal accessory nerve sacrifice experience minimal functional deficits.
    • Trapezius muscle dysfunction can occur even when the spinal accessory nerve is preserved, indicating complex functional outcomes.