A case report of ansa cervicalis to spinal accessory transposition graft: a new surgical technique to prevent shoulder dysfunction.
| Autor: | Noel LM; Department of Otorhinolaryngology and Head and Neck Surgery, San Fernando Teaching Hospital., Medford SC; Department of Otorhinolaryngology and Head and Neck Surgery, San Fernando Teaching Hospital., Juman S; Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad and Tobago. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 May 08; Vol. 86 (6), pp. 3781-3785. Date of Electronic Publication: 2024 May 08 (Print Publication: 2024). |
| DOI: | 10.1097/MS9.0000000000002129 |
| Abstrakt: | Introduction and Importance: The spinal accessory nerve is at risk when performing neck dissections for head and neck cancers. Injury to this nerve can result in shoulder syndrome, which can be challenging to manage. Various nerve repair or grafting methods are available to prevent this condition. A safe, simple, and cost-effective option is the ansa cervicalis to spinal accessory transposition graft. Case Presentation: A 60-year-old Afro-Trinidadian female presented to the Outpatient clinic for evaluation of a scalp lesion and a large neck mass for a duration of one year. Preoperative tissue biopsies confirmed she had squamous cell cancer with metastatic spread to the cervical nodes. The patient underwent surgical excision of the scalp lesion and left neck dissection with the sacrifice of the sternocleidomastoid and the left spinal accessory nerve due to tumour involvement. During the procedure, the ansa cervicalis was successfully joined to the distal remainder of the spinal accessory nerve. After the surgery, the patient fully recovered and achieved a good quality of life during the 24-month follow-up. Clinical Discussion: This is the first reported case of using the ansa cervicalis to reinnervate the trapezius muscle through the spinal accessory nerve. This procedure aims to prevent pain, muscle wasting, and adhesive capsulitis. A quality-of-life questionnaire and adequate range of motion proved the success of this procedure, demonstrating that this option provides practical, functional, and aesthetic benefits for patients. Conclusion: The ansa cervicalis to spinal accessory transposition nerve graft is a valuable option for reinnervation. This case report highlights the effectiveness of this single-stage procedure in preventing shoulder syndrome. Competing Interests: There are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.) |
| Databáze: | MEDLINE |
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