10Mar 2020

SPINAL ACCESSORY NERVE: ANATOMICAL VARIATIONS AND ITS SIGNIFICANCE DURING NECK DISSECTION IN HEAD AND NECK CANCER

Crossref Cited-by Linking logo

  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Spinal accessory nerve plexus includes the spinal accessory nerve with all its Intra- and extracranial connections to other nerves. Neck dissection is an important technique for the treatment of cervical lymph node metastasis in patients with head and neck cancer. Due to the adverse effects of radical neck dissection, a progressively more conservative functional neck dissection including preservation of the spinal accessory nerve is no longer an exception. Iatrogenic injury to the spinal accessory nerve can have medico-legal implications. Despite the presence of many described techniques to locate the nerve, it still remains vulnerable to damage during neck dissection due to its variations in the course and relations with other structures. Since the introduction of functional neck dissection, various modi?cations have been made to reduce the adverse effects of radical neck dissection. This paper describes the variations of the spinal accessory nerve in the neck and surgical significance which will guide head and neck oncosurgeons in imbibing adequate knowledge and using efficient techniques during surgical neck dissections.

  1. J. Gardiner, B.W. Irvine, And A. Murray. Anomalous Relationship of the Spinal Accessory Nerve to the Internal Jugular Vein. Clinical Anatomy 2002;15:62?63.
  2. Crile G. Excision of cancer of the head and neck. JAMA 1906;47:1780?1786.
  3. Byers RM. Modified neck dissection: a study of 967 cases from 1970 to 80. Am J Surg1985;150:414?21.
  4. Robbins KT. Classification of neck dissection. Management of the neck in head and neck cancer, Part 1. Otolaryngol Clin N Am 1998;31:640?641.
  5. Suarez O. El problema de las metastasis linfaticas y alejadas del cancer de laringe e hipofaringe. Rev Otorrinolaryngol Santiago 1963;23:83?99.
  6. Williams PL, Warwick R. Gray?s anatomy. 36th Ed. Churchill, Livingstone: Oxford. p 1990;1082?1200.
  7. Brown H, Burns SK, Kaiser CN. The spinal accessory nerve plexus, the trapezius muscle and shoulder stabilization after radical neck cancer surgery. Ann Surg1988;296:654-661.
  8. Hamilton WJ, Boyd 10, Mossman HW 1966. Human Embryology, 3rd edition. Cambridge, UK: Heffer, p 416.
  9. San?udo J, Va?zquez R, Puerta J. Meaning and clinical interest of the anatomical variations in the 21st century. Eur J Anat2003;7(Suppl. 1):1?3.
  10. MIseri, E Ustundag, O Aydin. A rare anatomical variation of the spinal accessory nerve. The Journal of Laryngology & Otology 2007;121:277?278.
  11. Yuriko Hashimoto, Naoki Otsuki, Kouichi Morimoto, Miki Saito, Ken-ichiNibu. Four cases of spinal accessory nerve passing through the fenestrated internal jugular vein. SurgRadiolAnat2012;34:373?375.
  12. Hollinshead WH 1985. Anatomy for surgeons: the head and neck. Hoeber-Harper, New York, pp 497?498.
  13. Prades JM, Timoshenko A, Dumollard JM et al. High duplication of the internal jugular vein: clinical incidence in the adult and surgical consequences, a report of three clinical cases. SurgRadiolAnat2002;24:129?132.
  14. Lee SH, Lee JK, Jin SM et al. Anatomical variations of the spinal accessory nerve and its relevance to level IIb lymph nodes. Otolaryngol Head Neck 2009;141:639?644.
  15. Towbin AJ, Kanal E. A review of two cases of fenestrated internal jugular veins as seen by CT angiography. AJNR 2004;25:1433?1434.
  16. Williams PL, Warwick R, Dyson M, Bannister LH (eds.). 1989. Gray?s anatomy, 37th ed. Edinburgh: Churchill Livingston. p 584.
  17. Caliot P, Bousquet V, Midy D, Cabanie P. A contribution to the study of the accessory nerve: surgical implications. SurgRadiolAnat1989;11:11?15.
  18. Ayeni SA, Ohata K, Tanaka K, Hakuba A. The microsurgical anatomy of the jugular foramen. J Neurosurgery: 1995;3:903?909.
  19. Matthew L. Hinsley, MD, and Gregory K. Hartig, MD, Madison, WI. Anatomic relationship between the spinal accessory nerve and internal jugular vein in the upper neck. Otolaryngology?Head and Neck Surgery 2010;143, 239-241.
  20. Saman M, Etebari P, PakdamanMN. Anatomic relationship between the spinal accessory nerve and the jugular vein: a cadaveric study. SurgRadiolAnat2011;33:175?179.
  21. Alaani A, Webster K, Pracy JP. Duplication of internal jugular vein and relation to the spinal accessory nerve. Br J Oral MaxillofacSurg2005;43:528?31.
  22. J. Stacey, S.T. O?leary, and P.J. Hamlyn. An Anomaly in the Nerve Supply of the Trapezius Muscle. Clinical Anatomy 1996;9:414-416.
  23. Ueyama T, Satoda T, Tashiro T, Telsuo S, Matsushima R, Mizimo M. Infrahyoid and accessory motoneurons in the Japanese monkey (Macacafuscata). J Comp Neurol 291:373-382, 1990. 91.
  24. Reighard JE, Jennings HS. Anatomy of the Cat. New York: H. Holt and Co., pp115, 340-346, 382-383,1901. 92.
  25. Rose PR, Rierstad SA, Vanner SJ. A quantitative study of the geometry of the cat motoneurons innervating the neck and shoulder muscles. J Comp Neurol 29:89-107, 1985.
  26. Gurushanthiah M. Observations on the spinal nucleus of the accessory nerve in Bonnet Monkey (Macaca radiata). PhD thesis, Department of Anatomy. University of Madras, Madras, India, 1995.
  27. Kierner AC, Burian M, Bentzien S, Gstoettner W. Intraoperative electromyography for identification of the trapezius muscle innervation: clinical proof of a new anatomical concept. Laryngoscope 2002; 112: 1853-6.
  28. Piersol GA Ed. Human Anatomy. Philadelphia: JB Lippincott, p 1275,1911.
  29. Shiozaki K, Abe S, Agematsu H, Mitarashi S, Sakiyama K, Hashimoto M, et al. Anatomical study of accessory nerve innervation relating to functional neck dissection. J Oral MaxillofacSurg 2007; 65: 22-9.
  30. Dachaukar, A Pai, A K D?cruz. A technique to identify and preserve the spinal accessory nerve during neck dissection. The Journal of Laryngology & Otology 2006;120, 494?496.
  31. Henry Brown. Anatomy of the Spinal Accessory Nerve Plexus: Relevance to Head and Neck Cancer and Atherosclerosis. Exp Bioi Med Vol. 2002;227(8):570-578.

[Aviral Verma and Mohini Narang (2020); SPINAL ACCESSORY NERVE: ANATOMICAL VARIATIONS AND ITS SIGNIFICANCE DURING NECK DISSECTION IN HEAD AND NECK CANCER Int. J. of Adv. Res. 8 (Mar). 1150-1154] (ISSN 2320-5407). www.journalijar.com

Aviral Verma
Fortis Escorts Heart Institute and Research Centre

DOI:

Article DOI: 10.21474/IJAR01/10735      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10735

Download Full Paper

Download PDF No. of Downloads: 56 | No. of Views: 132