<abstract xmlns="http://www.w3.org/1999/xhtml"> Background. In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND). Methods. The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor. Results. The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified. In type 1 nerve exits at the posterior end of the sternocleidomastoid muscle (SCm) and then it enters the level V (66%). In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%). In type 3 the nerve exits at the posterior part of the SCm and it joins to the cervical plexus (12%). The nerve than exits this junction more medially as a single trapezius branch. Conclusions. The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.</abstract>

Background. In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND). Methods. The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor. Results. The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified. In type 1 nerve exits at the posterior end of the sternocleidomastoid muscle (SCm) and then it enters the level V (66%). In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%). In type 3 the nerve exits at the posterior part of the SCm and it joins to the cervical plexus (12%). The nerve than exits this junction more medially as a single trapezius branch. Conclusions. The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.

Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping

Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Medical Center Maribor, Slovenia

Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Slovenia

Institute of Clinical Neurophysiology, University Medical Center Ljubljana, Slovenia

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background. In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified...

Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping

Published Online: Nov 05, 2014

Page range: 387 - 392

Received: Aug 16, 2013

Accepted: Sep 03, 2013

DOI: https://doi.org/10.2478/raon-2013-0069

Keywords
spinal accessory nerve, nerve mapping, neck dissection, anatomy, shoulder disability

© by Bostjan Lanisnik

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping

Published Online: Nov 05, 2014

Page range: 387 - 392

Received: Aug 16, 2013

Accepted: Sep 03, 2013

DOI: https://doi.org/10.2478/raon-2013-0069

Keywordsspinal accessory nerve, nerve mapping, neck dissection, anatomy, shoulder disability

© by Bostjan Lanisnik

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
spinal accessory nerve, nerve mapping, neck dissection, anatomy, shoulder disability