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Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping.

Lanisnik B, Zargi M, Rodi Z - Radiol Oncol (2014)

Bottom Line: In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%).The nerve than exits this junction more medially as a single trapezius branch.The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Medical Center Maribor, Slovenia.

ABSTRACT

Background: In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND).

Methods: The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor.

Results: The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified. In type 1 nerve exits at the posterior end of the sternocleidomastoid muscle (SCm) and then it enters the level V (66%). In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%). In type 3 the nerve exits at the posterior part of the SCm and it joins to the cervical plexus (12%). The nerve than exits this junction more medially as a single trapezius branch.

Conclusions: The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.

No MeSH data available.


Related in: MedlinePlus

In type 1 pattern, a trapezius branch exits at the posterior margin of the sternocleidomastoid muscle, deep to the cervical nerves, and continues to enter level V. Cervical roots are displaced with suture loops for better visualization of the trapezius branch. This pattern was present in 69% of the patients.
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f2-rado-48-04-387: In type 1 pattern, a trapezius branch exits at the posterior margin of the sternocleidomastoid muscle, deep to the cervical nerves, and continues to enter level V. Cervical roots are displaced with suture loops for better visualization of the trapezius branch. This pattern was present in 69% of the patients.

Mentions: Type 1 pattern of the accessory nerve was the most common and was found in 49 out of 74 heminecks (66%). In this pattern, the nerve coursed through the sternocleidomastoid muscle, where it divided into the sternocleidomastoid branch and trapezius branch. The latter exited the muscle at its posterior edge and is readily identified in the posterior part of region V and deep to the plane of the cervical roots (Figure 2).


Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping.

Lanisnik B, Zargi M, Rodi Z - Radiol Oncol (2014)

In type 1 pattern, a trapezius branch exits at the posterior margin of the sternocleidomastoid muscle, deep to the cervical nerves, and continues to enter level V. Cervical roots are displaced with suture loops for better visualization of the trapezius branch. This pattern was present in 69% of the patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230559&req=5

f2-rado-48-04-387: In type 1 pattern, a trapezius branch exits at the posterior margin of the sternocleidomastoid muscle, deep to the cervical nerves, and continues to enter level V. Cervical roots are displaced with suture loops for better visualization of the trapezius branch. This pattern was present in 69% of the patients.
Mentions: Type 1 pattern of the accessory nerve was the most common and was found in 49 out of 74 heminecks (66%). In this pattern, the nerve coursed through the sternocleidomastoid muscle, where it divided into the sternocleidomastoid branch and trapezius branch. The latter exited the muscle at its posterior edge and is readily identified in the posterior part of region V and deep to the plane of the cervical roots (Figure 2).

Bottom Line: In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%).The nerve than exits this junction more medially as a single trapezius branch.The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Medical Center Maribor, Slovenia.

ABSTRACT

Background: In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND).

Methods: The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor.

Results: The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified. In type 1 nerve exits at the posterior end of the sternocleidomastoid muscle (SCm) and then it enters the level V (66%). In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%). In type 3 the nerve exits at the posterior part of the SCm and it joins to the cervical plexus (12%). The nerve than exits this junction more medially as a single trapezius branch.

Conclusions: The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.

No MeSH data available.


Related in: MedlinePlus