The neurologic deficit caused by the cranial positioning of the right diaphragm due to the injuryofthe phrenic nerve, as well as from the spinal accessory nerve
injury, reduced this patient's quality of life.
RNS was performed in the following muscles: deltoid for the axillary nerve ( n = 51), trapezius for the accessory nerve
( n = 149, both sides tested in 5 cases), abductor digiti minimi (ADM) for the ulnar nerve ( n = 110), quadriceps femoris (QUA) for the femoral nerve ( n = 25), tibialis anterior (TIB) for the common peroneal nerve ( n = 50), and orbicularis oculi (ORB) for the facial nerve ( n = 8, both sides tested in 2 cases).
The anterolateral left cervical region after neck dissection with preservation of the spinal accessory nerve
, internal jugular vein and sternocleidomastoid muscle.
Specific care was executed during the dissection to avoid injury to the spinal accessory nerve
, which pass through the SCM.
The accessory nerve
(XI) was compressed between the osteochondroma and the deep layer of the trapezius; no muscle atrophy was described (Figure 3).
The spinal accessory nerve
(SAN) is unique in that it shares its innervation from both the medulla and the spinal cord.
Spinal accessory nerve
has been the most commonly used donor for restoration of shoulder abduction and external rotation with varying results in different centers16-18.
AN: accessory nerve
; red arrow: intramuscular nerve distribution; blue arrow: nerve entry point into the muscle.
Spinal accessory nerve
schwannoma involving the jugular foramen.
Furthermore, a report of an ultrasound examination of accessory nerve
lesions due to trauma in four cases, showed the feasibility of using this technique for the detection of pathological changes in the nerve following surgical procedures.
suggested a modified dissection preserving the jugular vein sternocleidomastoid muscle and spinal accessory nerve
based on an understanding of the facial planes and lymphatic anatomy of the neck.4 Bocca and Pig- nataro subsequently presented this procedure in the English-language literature and Ballantyne pioneered its use in the United States.5 Modified radical neck dissection (MRND) is often oncologically equivalent to radical neck dissection but with a significant reduction in postoperative morbidity gradually replaced radical neck dissection in the treatment of the neck for many patients with SCC of the oral cavity.6
The mandibular canal is referred to as a bilateral single structure; however, reports in the literature clearly show the presence of a second or even a third accessory nerve
This subluxation pattern shows manifestation or dysfunction of the tissues involving the brainstem, the vagal nerve or cranial nerve 10 and the spinal accessory nerve
or cranial nerve 11.
The distribution of 27 nerve of origins was 10 (37%) vagus nerves, 6 (22%) sympathetic trunks, 5 (19%) cervical plexuses, 3 (11%) brachial plexuses, 2 (7%) hypoglossal nerves, and 1 (4%) accessory nerve
The muscles affected are principally those supplied by the spinal accessory nerve
. The condition occur in animals, usually as a result of an inner ear infection but sometimes as a result of an injury (Kim et al., 2006).