A technique for preservation of spinal accessory nerve function in radical neck dissection

Area of Science:

• Neurosurgery
• Anatomy
• Surgical Technique

Background:

• Radical neck dissection often involves sacrificing the spinal accessory nerve, leading to trapezius muscle dysfunction and shoulder mobility loss.
• Preserving trapezius muscle function is crucial for patient quality of life after neck cancer surgery.

Observation:

• The trapezius muscle possesses dual innervation, receiving input from both the spinal accessory nerve and cervical nerves (C2-3-4).
• The spinal accessory nerve segment within the sternocleidomastoid muscle can be selectively sacrificed while preserving innervation from the cervical roots.

Findings:

• A new surgical technique described preserves trapezius muscle function during radical neck dissection.
• This technique leverages the dual innervation of the trapezius muscle, connecting the C2-3-4 motor root to the distal spinal accessory nerve.
• Utilizing a gastrointestinal stapler in the scalene fat pad allows for rapid implementation of this nerve-sparing approach.

Implications:

• This procedure is expected to maintain shoulder mobility in the majority of patients undergoing radical neck dissection.
• Improved functional outcomes and quality of life for patients undergoing neck dissection.
• Potential for wider adoption of nerve-preserving techniques in head and neck oncology surgery.