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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 2 pattern, a trapezius branch exits the main trunk at level IIa and continues superficial to the cervical nerves in level IIa and enters level V. In this figure, we can see that it is essential to identify this branch early during the dissection in level IIa. This pattern was found in 20% of patients.
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f3-rado-48-04-387: In type 2 pattern, a trapezius branch exits the main trunk at level IIa and continues superficial to the cervical nerves in level IIa and enters level V. In this figure, we can see that it is essential to identify this branch early during the dissection in level IIa. This pattern was found in 20% of patients.

Mentions: Type 2 pattern was identified in 16 out of 74 heminecks (22%). In this case the branch for the trapezius muscle branched off the common trunk before entering the sternocleidomastoid muscle. The course of this branch is superficial to the cervical roots at least to the level of C4, where it coursed deep and entered region V and the trapezius muscle (Figure 3).


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 2 pattern, a trapezius branch exits the main trunk at level IIa and continues superficial to the cervical nerves in level IIa and enters level V. In this figure, we can see that it is essential to identify this branch early during the dissection in level IIa. This pattern was found in 20% of patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3-rado-48-04-387: In type 2 pattern, a trapezius branch exits the main trunk at level IIa and continues superficial to the cervical nerves in level IIa and enters level V. In this figure, we can see that it is essential to identify this branch early during the dissection in level IIa. This pattern was found in 20% of patients.
Mentions: Type 2 pattern was identified in 16 out of 74 heminecks (22%). In this case the branch for the trapezius muscle branched off the common trunk before entering the sternocleidomastoid muscle. The course of this branch is superficial to the cervical roots at least to the level of C4, where it coursed deep and entered region V and the trapezius muscle (Figure 3).

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