VOLUME 4 , ISSUE 1 ( January-April, 2013 ) > List of Articles
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: 01-08-2014
Copyright Statement: Copyright © 2013; The Author(s).
To assess preoperative and postoperative shoulder function by electromyography (EMG) in spinal accessory nerve (SAN) sparing neck dissections in head and neck cancers. 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. 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. 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. 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.