A Novel Approach to Identifying the Spinal Accessory Nerve in Surgical Neck Dissection
Abstract
Intraoperative identification of the spinal accessory nerve (SAN) is key in reducing nerve injury. This study aims to explore the surgical anatomy of the SAN and 2 landmarks for its identification—the sternocleidomastoid branch of the occipital artery (SBOA) and superior sternocleidomastoid tendon (SST)—to propose a novel method of identifying the SAN during surgical neck dissections. Twelve cadavers underwent bilateral level II-V neck dissection identifying the SAN, SBOA,
and SST. Variation was documented and distance between landmarks and the SAN measured. The most common arrangement had the SST most superficially followed by the SBOA and then the SAN. The SAN was 3.63 6 4.02 mm from the artery and 2.31 6 1.72 mm from the tendon. A triangle—bordered by the tendon laterally, artery medially, and digastric muscle superiorly—contained the SAN in 95.8% of cases. This relationship translated into a reliable technique to identify the SAN intraoperatively, which has been used successfully in practice.
Acceptance Date | Mar 20, 2018 |
---|---|
Publication Date | Mar 20, 2018 |
Journal | Otolaryngology–Head and Neck Surgery |
Print ISSN | 0194-5998 |
Publisher | SAGE Publications |
Pages | 300 - 302 |
DOI | https://doi.org/10.1177/0194599818766057 |
Keywords | surgical neck dissection, spinal accessory nerve, surgical landmarks, surgical anatomy |
Publisher URL | https://journals.sagepub.com/doi/10.1177/0194599818766057 |
Downloadable Citations
About Keele Repository
Administrator e-mail: research.openaccess@keele.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search