Free grafts of the spinal accessory nerve during radical neck dissection

Anatomical Study of Accessory Nerve Innervation Relating to Functional Neck Dissection

“…In addition, the accessory nerve is a major motor nerve that innervates the trapezius muscle, and the results of this study show that the main trunk of the accessory nerve anastomoses to a branch of the cervical nerve before reaching the trapezius muscle. While this anastomosing branch between the cervical and accessory nerves has been reported in the past (23) , whether the anastomosing branch includes centrifugal fibers has not been clarified (23)(24)(25)(26) . Previous results have shown that motor nerves are sometimes included (27)(28)(29)(30)(31)(32) .…”

Motor Innervation of the Trapezius Muscle: Intraoperative Motor Conduction Study during Neck Dissection

“…Along with the SAN, the cervical nerves either run independently to the trapezius muscle or form a plexus with the SAN before entering this muscle [12]. It is well known that the cervical plexus and SAN innervate the transverse and ascending portions, but only a single branch of the SAN supplies the descending portion [13,14]. However, reports as to the segmental innervation level of the trapezius muscle, views on where the branches of the cervical plexus join the SAN in playing their role, and opinions about whether their role is independent of the SAN differ in the literature [15,16,17,18].…”

Treatment of scapular winging with modified Eden-Lange procedure in patient with pre-existing glenohumeral instability

“…4,7,13,17 Treatments for spinal accessory nerve injury, such as nerve exploration with neurolysis, direct nerve repair, or nerve grafting, might be successful if performed within 6 months of some injuries. 1,7,9,14,18,20 However, our patient was injured 4 years before surgery, which made primary repair options or nerve grafting unfeasible. Conservative treatment and physical therapy for spinal accessory nerve injuries have been shown to be unsuccessful because of the inability to adequately strengthen adjacent muscle groups to compensate for the trapezius palsy.…”