Functional evaluation of the spinal accessory nerve after neck dissection

Area of Science:

• Surgical Oncology
• Neurosurgery
• Anatomy

Background:

• Radical neck dissection can lead to significant pain and dysfunction due to spinal accessory nerve denervation.
• Surgical modifications aim to mitigate these negative functional outcomes.

Purpose of the Study:

• To compare the functional outcomes and pain levels associated with modified radical neck dissection techniques versus the classic procedure.
• To evaluate the impact of preserving the spinal accessory nerve, muscle, and vein.

Main Methods:

• A prospective study involving 109 patients undergoing radical neck dissection or its modifications.
• Comparison of functional disability and pain scores based on the extent of nerve and surrounding tissue preservation.

Main Results:

• Preservation of the nerve, muscle, and vein resulted in the lowest dysfunction rate (30%).
• Nerve preservation alone showed 50% dysfunction, while classic dissection had 60%.
• Nerve-sparing procedures were associated with less pain, even with similar disability levels.

Conclusions:

• Modifications to radical neck dissection that preserve the spinal accessory nerve, muscle, and vein improve functional outcomes and reduce pain.
• Further prospective studies on recurrence rates are warranted for these modified techniques.