Accessory nerve damages and impaired shoulder movements after neck dissections

American Journal of Otolaryngology
K Miyata, H Kitamura

Abstract

After neck dissection, where the accessory nerve is often excised patients usually complain of impaired shoulder movements. The accessory nerve forms a plexus with branches of the cervical nerves C2, C3, and C4. In the present study, the accessory nerve was examined during neck dissections to clarify the incidence of motor fibers in joining branches, and the function of the motor fibers was evaluated postoperatively in relation to shoulder movements. Presence of cervical contributions to the accessory nerve were examined in 20 neck sides in 15 patients. Postoperative function of the shoulder movements was evaluated by manual muscle testing (MMT) and electromyography (EMG). Motor fibers in cervical contributions were noted on four sides (20%) by stimulation of joining branches. When the accessory nerve was excised, scapular elevation was rarely impaired even if there were no motor fibers in the cervical contributions. Excision of the accessory nerve caused poor scapular adduction and impaired scapular depression and adduction in most cases even if motor fibers in the cervical contributions existed. Postoperative impairment of scapular movements was not attributed to the presence or absence of motor fibers in joining branches. Re...Continue Reading

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Citations

Apr 5, 2002·Muscle & Nerve·Scott M FriedenbergC Michel Harper
Jul 22, 2010·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Matthew L Hinsley, Gregory K Hartig
Apr 3, 2001·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·Z H DailianaA Gilbert
Aug 10, 2002·The Laryngoscope·Grazia SalernoVieri Galli
Apr 7, 2007·Current Opinion in Otolaryngology & Head and Neck Surgery·Johnny CappielloPiero Nicolai
Jun 19, 2008·The Journal of Orthopaedic and Sports Physical Therapy·Martin J KelleyBrian G Leggin
Jan 6, 2007·The Laryngoscope·Tetsuya TsujiMeigen Liu
Oct 9, 2002·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Gerd BodnerAmmar Mallhoui
Oct 18, 2002·Clinical Otolaryngology and Allied Sciences·F El GhaniL E Smeele

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