MODIFIED RADICAL NECK DISSECTION PRESERVING SPINAL ACCESSORY NERVE [chapter]

Anna M. Pou
2010 Atlas of General Surgical Techniques  
Aim: Th e aim of this study was to evaluate shoulder functions aft er neck dissection with preservation of the spinal accessory nerve by objective physical examination, electromyographic fi ndings, and subjective patient complaints, and also to investigate the eff ect of the type of neck dissection. Materials and methods: Th e present study included 29 patients on whom unilateral selective or modifi ed radical neck dissection was performed for head and neck cancer and/or metastasis to the neck.
more » ... stasis to the neck. Electromyographical fi ndings, range of motion, and pain scores of the shoulder joint were determined for the operated and nonoperated (control) sides. Results: An electromyographic examination of the trapezius and sternocleidomastoid muscle with superfi cial and pin electrodes showed a statistically signifi cant diff erence when comparing the latency and amplitude values of the operated and nonoperated sides (P < 0.05). Flexion, abduction, and external rotation of the shoulder joint were found to be signifi cantly aff ected on the operated side (P < 0.05). Electrophysiological diff erences were not found with regards to neck dissection types. Mild or moderate pain was observed at the early stage with a visual pain scale. Conclusion: Despite spinal accessory nerve preservation during neck dissection, electrophysiological changes and alterations in clinical functions might be seen in all areas of the nerve that innerves the shoulder muscles.
doi:10.1016/b978-0-7216-0398-8.50006-1 fatcat:yqo5ahfjenfvnh5t7yweuwej3i