Occurrence, Duration and Prognosis of Unexpected Accessory Nerve Paresis in Radical Neck Dissection

Anatomical Study of Accessory Nerve Innervation Relating to Functional Neck Dissection

“…However, as with radical neck dissection, postoperative dysfunction following functional neck dissection has been reported (17) .…”

Trapezius muscle innervation from the spinal accessory nerve and branches of the cervical plexus

“…Sectioning of the accessory nerve during radical neck dissection does not always result in disability of shoulder function 1,7,13 . To explain this phenomenon, SOO et al 14 performed a series of anatomical analyses in cadavers, in which they observed direct contributions from the C2, C3 and C4 branches of the cervical plexus to the trapezius muscle, besides the accessory nerve.…”

“…Sectioning of the accessory nerve during radical neck dissection can result in atrophy of the trapezius muscle and shoulder dysfunction, involving shoulder droop, pain, weakness, and a limited range of motion called 'shoulder syndrome' 1,10 . To avoid this serious complication, most surgeons perform a type of modified neck dissection in which the accessory nerve is spared 3,8,12 .…”

Upper limb dysfunction following selective neck dissection: A retrospective questionnaire study

“…The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections. [2][3][4] This has been attributed to sacrifice of the spinal accessory nerve intraoperatively. The accessory nerve innervates the sternocleidomastoid and trapezius muscles, with the middle and lower fibers also receiving motor branches from the posterior parts of C3 and C4.…”