Shoulder function after accessory nerve–sparing neck dissections

Abstract

ART does not have a negative effect on shoulder function after ND. SAN is always functionally impaired even if we preserve it macroscopically during ND.

Preservation of Spinal Accessory Nerve during Radical Neck Dissection

“…Postoperative exercises are mandatory to prevent the shoulder syndrome. Doubts have been expressed by some workers whether maintaining physical integrity of the SAN actually leads to preservation of its function [7].…”

Larenks kanserli hastalarda adjuvant radyoterapinin ses ve yaşam kalitesi ile ilişkisi

“…[15][16][17] and the effect of protecting accessory nerves on shoulder functions. 1,[18][19][20][21] However, best of our knowledge, there was no study assessed the correlation between voice quality and QOL in patients with larynx cancer. In our study we evaluated QOL in larynx cancer patients according to treatment type, surgery type, administration of RT and voice changes.…”

Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

“…Functional outcomes following RND are inferior to spinal accessory nerve-sparing procedures due to the resultant chronic trapezius dysfunction. 7,9,13,33,43,50,53 The MRND and SND procedures were developed to spare the spinal accessory nerve, thus limit trapezius dysfunction; however, significant incidence of spinal accessory nerve injury has been reported 6,10,13,14,52,53 that might have resulted from nerve manipulation. 6,29,43,50,52 The MRND requires lymph node dissection at all levels, but the spinal accessory nerve is usually spared.…”

“…6,7,15,46,53 Dynamically, trapezius dysfunction results in dramatically altered scapular kinematics and limited shoulder elevation. 7,13,14,22,46,53 Diagnosis of SANP is typically achieved by identifying associated signs such as trapezius atrophy, depressed shoulder girdle, scapular dyskinesis, trapezius weakness, and limited shoulder active abduction. 6,9,11,[13][14][15]28,29,31,46,48,49,53,52 Unfortunately, many of these signs are observational and unreliably recognized, which may explain a high rate of misdiagnosis.…”

“…40 Spinal accessory nerve injury commonly occurs during neck dissection surgery. 2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 Neck dissection surgery is performed to treat head and neck carcinoma and is categorized into 3 different procedures: radical S pinal accessory nerve palsy (SANP) is common following neck dissection surgery or lymph node excision, 2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 blunt or penetrating trauma to the lateral neck region, 2,11 and cervical stretch injuries. 32 Spinal accessory nerve injury results in trapezius paralysis or dysfunction and a diagnostic cluster of signs and symptoms, including shoulder girdle depression, trapezius atrophy, scapular dyskinesis, loss of shoulder STUDY DESIGN: Retrospective case series.…”