Morphology and Functionof the Shoulder after Neck Dissections with Preservation the Accessory Nerve

Overview

The paper deals with a retrospective evaluation of the accessory nerve and trapeziusmuscle function after modified radical and selective neck dissections. In the period from 1/1995 till3/2000 a total of 98modified radical and selective neck dissections were made at the OtolaryngologyWard of the Central Military Hospital, Prague. Thirty eight patients (43%) were invited and 29 ofthemshowed up (76% of the invited patients), having undergone forty seven neck dissections before.All patients were asked to report their subjective complaints and morphological and functionconditions of the shoulder was examined and EMG examinations of the accessory nerve and thetrapezius muscle were performed. Subjective complaints after the operation were reported by fivepatients (17%), pathological morphological and functional condition of the shoulder was found insix cases (13%), while normal finding was present in 41 cases (87%). The EMG examination of thetrapezius muscle did not reveal denervation potentials at rest and the intentional EMG activityreached the 4th to 5th degree, i.e. adequate intentional activity, in all cases. In the EMGexaminationof the accessory nerve, adequate motor conduction was observed in 41 cases (87%), disorder in motorconduction of the accessory nervewere verified in six cases (13%), but motor activity of the accessorynerve could not be elicited in one case only (2%). In five patients withdama ge of the accessory nervethe authors demonstrated correlation between subjective complaints,morphological and functionalcondition of the shoulder and EMG examination of the accessory nerve.

Key words:
shoulder, the accessory nerve, the trapezius muscle, drop shoulder syndrome.