Spinal accessory nerve function after neck dissections. 2007

K S Orhan, and T Demirel, and B Baslo, and E K Orhan, and E A Yücel, and Y Güldiken, and K Değer
Capa Hospital, Istanbul, Turkey.

The aim of this study was to evaluate spinal accessory nerve function after functional neck dissection (FND) and radical neck dissection (RND) by monitoring the nerve with electromyographic (EMG) examinations. A prospective, double-blind, clinical study was undertaken in 21 patients (42 neck side dissections) operated on for head and neck malignant diseases, separated into two groups: 10 neck sides in the RND group and 32 neck sides in the FND group. Electromyographic examinations were performed pre-operatively and post-operatively in the third week and third and ninth months. Additionally, a questionnaire, modified from the neck dissection impairment index, was applied to all the patients in order to assess shoulder function in the ninth post-operative month. All patients had maximum EMG scores pre-operatively. Following the operation, motor amplitudes decreased in both groups. At the third post-operative month, amplitudes decreased to their lowest values. As expected, the decreases in amplitude and EMG score were more prominent in the RND group. Following reinnervation, the amplitudes of the trapezius motor response increased in the FND group but never reached pre-operative values (during the time of follow up). The FND group scores for pain, neck and shoulder stiffness, and disability in heavy object lifting, light object lifting and reaching overhead were significantly lower than those of the RND group. In FND, one aims to preserve anatomically the spinal accessory nerve, and it is presumed to be intact after the procedure. However, using EMG nerve function monitoring, our study revealed that profound spinal nerve injury was detected immediately after FND surgery, which tended to improve over subsequent months but had not regained its original function by the end of the ninth post-operative month.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260 Female Females
D006258 Head and Neck Neoplasms Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651) Cancer of Head and Neck,Head Cancer,Head Neoplasm,Head and Neck Cancer,Head and Neck Neoplasm,Neck Cancer,Neck Neoplasm,Neck Neoplasms,Neoplasms, Upper Aerodigestive Tract,UADT Neoplasm,Upper Aerodigestive Tract Neoplasm,Upper Aerodigestive Tract Neoplasms,Cancer of Head,Cancer of Neck,Cancer of the Head,Cancer of the Head and Neck,Cancer of the Neck,Head Neoplasms,Head, Neck Neoplasms,Neoplasms, Head,Neoplasms, Head and Neck,Neoplasms, Neck,UADT Neoplasms,Cancer, Head,Cancer, Neck,Cancers, Head,Cancers, Neck,Head Cancers,Neck Cancers,Neoplasm, Head,Neoplasm, Neck,Neoplasm, UADT,Neoplasms, UADT
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D061227 Accessory Nerve Injuries Traumatic injuries to the ACCESSORY NERVE. Damage to the nerve may produce weakness in head rotation and shoulder elevation. Accessory Nerve Avulsion,Accessory Nerve Contusion,Accessory Nerve Transection,Accessory Nerve Trauma,Accessory Neuropathy, Traumatic,Cranial Nerve XI Injury,Eleventh Cranial Nerve Injuries,Eleventh Cranial Nerve Injury,Eleventh-Nerve Palsy, Traumatic,Eleventh-Nerve Trauma,Injury, Cranial Nerve XI,Injury, Eleventh Cranial Nerve,Spinal Accessory Nerve Avulsion,Spinal Accessory Nerve Contusion,Spinal Accessory Nerve Injury,Spinal Accessory Nerve Transection,Spinal Accessory Nerve Trauma,Spinal Accessory Neuropathy, Traumatic,Traumatic Eleventh-Nerve Palsy,Accessory Nerve Avulsions,Accessory Nerve Contusions,Accessory Nerve Injury,Accessory Nerve Transections,Accessory Nerve Traumas,Accessory Neuropathies, Traumatic,Avulsion, Accessory Nerve,Avulsions, Accessory Nerve,Contusion, Accessory Nerve,Contusions, Accessory Nerve,Eleventh Nerve Palsy, Traumatic,Eleventh Nerve Trauma,Eleventh-Nerve Palsies, Traumatic,Eleventh-Nerve Traumas,Injuries, Accessory Nerve,Injury, Accessory Nerve,Nerve Avulsion, Accessory,Nerve Avulsions, Accessory,Nerve Contusion, Accessory,Nerve Contusions, Accessory,Nerve Injuries, Accessory,Nerve Injury, Accessory,Nerve Transection, Accessory,Nerve Transections, Accessory,Nerve Trauma, Accessory,Nerve Traumas, Accessory,Neuropathies, Traumatic Accessory,Neuropathy, Traumatic Accessory,Palsies, Traumatic Eleventh-Nerve,Palsy, Traumatic Eleventh-Nerve,Transection, Accessory Nerve,Transections, Accessory Nerve,Trauma, Accessory Nerve,Trauma, Eleventh-Nerve,Traumas, Accessory Nerve,Traumas, Eleventh-Nerve,Traumatic Accessory Neuropathies,Traumatic Accessory Neuropathy,Traumatic Eleventh Nerve Palsy,Traumatic Eleventh-Nerve Palsies

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