Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-12-2016 | Head and Neck

The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection

Authors: Boštjan Lanišnik, Lidija Žitnik, Primož Levart, Miha Žargi, Zoran Rodi

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2016

Abstract

Intraoperative monitoring of the cranial nerve XI (CN XI) may decrease shoulder disability following modified radical neck dissection. Prospective study was designed comparing results of Constant Shoulder Score (CSS), Shoulder Pain and Disability Index (SPADI) and EMG score of the trapezius muscle (mT) before and after surgery. One side of the neck was monitored during surgery with intraoperative nerve monitor. EMG scores of the mT 6 months postoperatively were statistically better on monitored as compared to the non-monitored side of the neck (p = 0.041), while the differences of the CSS and SPADI were not statistically significant. Patients with better EMG scores of the mT at 6 weeks recuperated better and with smaller decrease of the CSS. Intraoperative monitoring is beneficial at the beginning of the surgeon’s learning curve and in the process of familiarizing with anatomical variation of the CN XI.

Ahlberg A, Nikolaidis P, Engstrom T et al (2012) Morbidity of supraomohyoidal and modified radical neck dissection combined with radiotherapy for head and neck cancer: a prospective longitudinal study. Head Neck 34:66–72CrossRefPubMed

Chepeha DB, Taylor RJ, Chepeha JC et al (2002) Functional assessment using Constant’s Shoulder Scale after modified radical and selective neck dissection. Head Neck 24:432–436CrossRefPubMed

El Ghani F, Van Den Brekel MW, De Goede CJ, Kuik J, Leemans CR, Smeele LE (2002) Shoulder function and patient well-being after various types of neck dissections. Clin Otolaryngol Allied Sci 27:403–408CrossRefPubMed

Erisen L, Basel B, Irdesel J et al (2004) Shoulder function after accessory nerve-sparing neck dissections. Head Neck 26:967–971CrossRefPubMed

van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL (2003) Shoulder complaints after neck dissection; is the spinal accessory nerve involved? Br J Oral Maxillofac Surg 41:7–11CrossRefPubMed

Cappiello J, Piazza C, Giudice M, De Maria G, Nicolai P (2005) Shoulder disability after different selective neck dissections (levels II–IV versus levels II–V): a comparative study. Laryngoscope 115:259–263CrossRefPubMed

Tsuji T, Tanuma A, Onitsuka T et al (2007) Electromyographic findings after different selective neck dissections. Laryngoscope 117:319–322CrossRefPubMed

Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res (214):160–164

Constant CR, Gerber C, Emery RJ, Sojbjerg JO, Gohlke F, Boileau P (2008) A review of the Constant score: modifications and guidelines for its use. J Shoulder Elb Surg 17:355–361CrossRef

10.

Jamnik H, Spevak MK (2008) Shoulder Pain and Disability Index: validation of Slovene version. Int J Rehabil Res 31:337–341CrossRefPubMed

11.

Lanisnik B, Zargi M, Rodi Z (2014) Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping. Radiol Oncol 48:387–392CrossRefPubMedPubMedCentral

12.

Murer K, Huber GF, Haile SR, Stoeckli SJ (2011) Comparison of morbidity between sentinel node biopsy and elective neck dissection for treatment of the n0 neck in patients with oral squamous cell carcinoma. Head Neck 33:1260–1264CrossRefPubMed

13.

van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL (2004) Shoulder complaints after nerve sparing neck dissections. Int J Oral Maxillofac Surg 33:253–257CrossRefPubMed

14.

Coskun HH, Erisen L, Basut O (2004) Selective neck dissection for clinically N0 neck in laryngeal cancer: is dissection of level IIb necessary? Otolaryngol Head Neck Surg 131:655–659CrossRefPubMed

15.

Giordano L, Sarandria D, Fabiano B, Del Carro U, Bussi M (2012) Shoulder function after selective and superselective neck dissections: clinical and functional outcomes. Acta Otorhinolaryngol Ital 32:376–379PubMedPubMedCentral

16.

Medina JE, Byers RM (1989) Supraomohyoid neck dissection: rationale, indications, and surgical technique. Head Neck 11:111–122CrossRefPubMed

17.

Parikh S, Tedman BM, Scott B, Lowe D, Rogers SN (2012) A double blind randomised trial of IIb or not IIb neck dissections on electromyography, clinical examination, and questionnaire-based outcomes: a feasibility study. Br J Oral Maxillofac Surg 50:394–403CrossRefPubMed

18.

Lanisnik B, Zargi M, Rodi Z (2016) Electrophysiologic analysis of injury to cranial nerve XI during neck dissection. Head Neck 38(Suppl 1):E372–E376CrossRefPubMed

Title: The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection
Authors: Boštjan Lanišnik
Lidija Žitnik
Primož Levart
Miha Žargi
Zoran Rodi
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 12/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4096-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2016

The preservation of swollen middle ear mucosa could be important to the post-tympanoplasty audiologic outcome

Effects of ozone (O3) therapy on cisplatin-induced ototoxicity in rats

Core needle biopsy in the diagnosis of head and neck lesions: a retrospective study of 3 years

Is there a relationship between sphenoid sinus types, septation and symmetry; and septal deviation?

Dry and wet edges of traumatic tympanic membrane perforations

Facial palsy following cochlear implantation