International Journal of Head and Neck Surgery

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VOLUME 4 , ISSUE 1 ( January-April, 2013 ) > List of Articles

RESEARCH ARTICLE

Electromyographic Assessment of Accessory Nerve Function Following Nerve Sparing Neck Dissection

Sagaya Raj, Shuaib Merchant, Azeem Mohiyuddin, Oomen, Philip John Kottaram

Citation Information : Raj S, Merchant S, Mohiyuddin A, O, Kottaram PJ. Electromyographic Assessment of Accessory Nerve Function Following Nerve Sparing Neck Dissection. Int J Head Neck Surg 2013; 4 (1):19-23.

DOI: 10.5005/jp-journals-10001-1130

Published Online: 01-04-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims

To assess preoperative and postoperative shoulder function by electromyography (EMG) in spinal accessory nerve (SAN) sparing neck dissections in head and neck cancers.

Materials and methods

A prospective study was done on 50 patients (51 shoulders) with histopathologically proven head and neck cancers with N0 or N1 neck who underwent nerve sparing neck dissections. Patients were assessed preoperatively and postoperatively at 3 weeks and 3 months by needle EMG and muscle strength tests of upper trapezius.

Results

and interpretation: At 3 weeks postoperatively, 11 shoulders (39.3%) in FND group and four shoulders (33.3%) in modified radical neck dissection (MRND) group showed severely abnormal EMG, while in supraomohyoid neck dissection (SOHND) group only two (18.2%) shoulders showed severely abnormal EMG. All patients who underwent nerve sparing neck dissections showed improvement in at least one category on the second electromyogram at 3 months. This could be attributed to neuropraxia or transient devascularization of the accessory nerve. In our study, 11 patients in FND group showed severely abnormal EMG finding, but they did not have as great a degree of shoulder dysfunction as would be expected. This could be due to factors like preoperative condition of other synergistic shoulder girdle muscles, postoperative exercises, etc.

Conclusion

SAN injuries are common in all types of nerve sparing neck dissections requiring aggressive physiotherapy for an improved shoulder function. To conclude, in patients in whom it is oncologically sound, nerve sparing neck dissections offers significant benefit in terms of shoulder function.

How to cite this article

Mohiyuddin A, Raj S, Merchant S, Oomen, Kottaram PJ. Electromyographic Assessment of Accessory Nerve Function Following Nerve Sparing Neck Dissection. Int J Head and Neck Surg 2013;4(1):19-23.


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  1. Trends in incidence of head and neck cancers in India. Asian Pac J Cancer Prev 2007;8:607-12.
  2. Testing the muscles of the upper extremity. In: Daniels and Worthingham's muscle testing techniques of manual examination (8th ed). India: Elsevier 2007;69-79.
  3. Objective comparison of physical dysfunction after neck dissection. Am J Surg 1985;150:503-09.
  4. The 11th nerve syndrome in functional neck dissection. Laryngoscope 2002;112:1299-307.
  5. Accessory nerve function after modified radical and lateral neck dissections. Laryngoscope 2000;110:73-77.
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