Quantification of Trapezius Muscle Innervation During Neck Dissections: Cervical Plexus Versus the Spinal Accessory Nerve.

Autor:	Svenberg Lind C; Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden clara.svenberg-lind@karolinska.se., Lundberg B; Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden., Hammarstedt Nordenvall L; Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden., Heiwe S; Karolinska Institutet, Stockholm, Sweden., Persson JK; Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden., Hydman J; Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2015 Nov; Vol. 124 (11), pp. 881-5. Date of Electronic Publication: 2015 Jun 01.
DOI:	10.1177/0003489415589365
Abstrakt:	Objectives: Despite increasing use of selective, nerve-sparing surgical techniques during neck dissections, the reported rate of postoperative paralysis of the trapezius muscle is still high. The aim of the study is to measure and compare motor inflow to the trapezius muscle, in order to better understand the peripheral neuroanatomy. Methods: Intraoperative nerve monitoring (electroneurography) in patients undergoing routine neck dissection (n=18). The innervation of the 3 functional parts of the trapezius muscle was mapped and quantified through compound muscle action potentials. Results: In 18/18 (100%) of the patients, the spinal accessory nerve (SAN) innervated all parts of the trapezius muscle. In 7/18 (39%) of the patients, an active motor branch from the cervical plexus was detected, equally distributed to all functional parts of the trapezius muscle, at levels comparable to the SAN. Conclusions: Compared to the SAN, branches from cervical plexus provide a significant amount of neural input to all parts of the trapezius muscle. Intraoperative nerve monitoring can be used in routine neck dissections to detect these branches, which may be important following surgical injury to the SAN. (© The Author(s) 2015.)
Databáze:	MEDLINE
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