Functional Recovery following an End to Side Neurorrhaphy of the Accessory Nerve to the Suprascapular Nerve: Case Report

Abstract

The use of end-to-side neurrorhaphy remains a controversial topic in peripheral nerve surgery. The authors report the long-term functional outcome following a modified end-to-side motor reinnervation using the spinal accessory to innervate the suprascapular nerve following a C5 to C6 avulsion injury. Additionally, functional outcomes of an end-to-end neurotization of the triceps branch to the axillary nerve and double fascicular transfer of the ulnar and medial nerve to the biceps and brachialis are presented. Excellent functional recoveries are found in respect to shoulder abduction and flexion and elbow flexion.

Reverse End-to-Side Nerve Transfer: From Animal Model to Clinical Use

“…[17][18][19][20][21][22] Since that time, the clinical use of ETS nerve transfer has been controversial. 22,23 Although functional motor recovery after ETS nerve transfer has been reported, 24 results have been conflicting, with sensory recovery typically being more successful than motor recovery. 25 Many animal studies have been performed in an attempt to clarify technical requirements for a successful ETS nerve transfer.…”

Nerve Transfers: Indications, Techniques, and Outcomes

“…The latter maneuver is a second degree of axonotmetic injury and will allow less donor nerve deficit because it stimulates distal motor endplate collateral sprouting. 13 The internal topography of both the median and ulnar nerves at the wrist is well defined and predictable. The motor and sensory components of each nerve are readily identified and separated.…”

Restoration of Trigeminal Cutaneous Sensation with Cross-Face Sural Nerve Grafts

“…Nerve transfers have the advantage of direct neurotization, but they suffer from their restricted arc of rotation, limiting their application. 13 Although cross-face nerve grafting requires donor nerve harvest, there is minimal associated morbidity, 14 and the length of harvested nerve grafts permits reconstruction even when donor and recipient nerves are not immediately adjacent. 13,15 An epineurial window and partial axonal injury were used in each case above.…”