Spinal accessory nerve functions after functional and lateral neck dissections: an electromyographic study

Year 2007, Volume: 17 Issue: 4, 201 - 205, 01.07.2007

İmdat Yüce Sedat Çağlı Emel Köseoğlu Ercihan Güney

Abstract

Objectives: This study was designed to determine electromyographic findings of the spinal accessory nerve SAN after elective functional level ll-V and lateral neck dissections level ll-IV in No patients with supraglottic larynx carcinoma.Patients and Methods: The study included 10 patients five bilateral who underwent functional FND , and 10 patients ali bilateral who underwent lateral LND neck dissection for supraglottic larynx carcinoma. Those with a history of myopathy, neu- ropathy, recurrent disease, or previous radiotherapy were excluded. Functions of the SAN were evaluat- ed with EMG after at least 12 months postoperative- ly. The results were assessed in four groups as nor­ mal functions, or neurogenic deficit of mild, moder- ate, or severe degree.Results: Neurogenic deficits were found in the ster- nocleidomastoid muscle in eight necks 53.3% and in the trapezius muscle in seven necks 46.6% in the FND group. However, only two necks 10% exhibited neurogenic deficits affecting both muscles in the LBD group. Comparison between the two groups showed a significant difference in terms of SAN functions p<0.05 .Conclusion: Compared to FND, LND is associated with significantly less neurogenic damage sec- ondary to SAN dissection.

Keywords

Accessory nerve/injuries, electromyography, laryngeal neoplasms/surgery, neck dissection, neck muscles/injuries

Fonksiyonel ve lateral boyun diseksiyonu sonrasında spinal aksesuvar sinir fonksiyonları: Elektromiyografik çalışma

Abstract

Amaç: Supraglottik larenks karsinomlu N0hastalarda, elektif fonksiyonel seviye II-V ve lateral seviyeII-IV boyun diseksiyonu sonrasında spinal aksesuvar sinir SAS fonksiyonları elektromiyografi EMG ile değerlendirildi.Hastalar ve Yöntemler: Supraglottik larenks kanseri nedeniyle fonksiyonel boyun diseksiyonu FBD yapılan on hasta beşi iki taraflı ve lateral boyun diseksiyonu LBD yapılan on hasta tümü iki taraflı çalışmaya alındı. Miyopati, nöropati, nüks etmiş hastalığı olanlar ve radyoterapi gören hastalar çalışmadışı bırakıldı. Hastalarda ameliyattan en az bir yılsonra SAS fonksiyonları EMG ile değerlendirildi.Elektromiyografi sonuçları, normal fonksiyon, hafif,orta derecede ve ağır nörojenik hasar olmak üzeredört grupta değerlendirildi.Bulgular: Elektromiyografi çalışmaları sonucunda,FBD yapılan grupta sternokleidomastoid kasında SKM sekiz boyunda %53.3 , trapez kasında iseyedi boyunda %46.6 nörojenik hasar saptandı. Lateral boyun diseksiyonu yapılan grupta ise iki boyunda %10 her iki kasta nörojenik hasar saptandı. İkigrup arasında SAS fonksiyonları açısından anlamlıfark vardı p

Keywords

Aksesuvar sinir/yaralanma, elektromiyografi, larenks neoplazileri/cerrahi, boyun diseksiyonu, boyun kasları/yaralanma

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