Radical neck dissection: preserving the distal spinal accessory nerve based on its cervical plexus contribution

J Surg Oncol. 2008 Sep 1;98(3):200-1. doi: 10.1002/jso.21090.

Abstract

In an effort to overcome shoulder morbidity from the classical radical neck dissection, modifications preserving the entire spinal accessory nerve, were described. When there are metastatic upper jugular nodes with potential extracapsular spread, modifications that preserve the entire XI nerve may be oncologically unsafe. We describe a technique wherein the XI nerve is preserved based on the contribution from the cervical plexus, while allowing resection of the proximal part of the nerve en bloc with the specimen. This modification may preserve useful trapezius function without compromising oncological safety.

MeSH terms

  • Accessory Nerve / physiopathology*
  • Accessory Nerve / surgery
  • Cervical Plexus / physiopathology*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Neck Dissection*