Yüce Imdat, Cağli Sedat, Köseoğlu Emel, Güney Ercihan
Department of Otolaryngology, Medicine Faculty of Erciyes University, Kayseri, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(4):201-5.
This study was designed to determine electromyographic findings of the spinal accessory nerve (SAN) after elective functional (level II-V) and lateral neck dissections (level II-IV) in N0 patients with supraglottic larynx carcinoma.
The study included 10 patients (five bilateral) who underwent functional (FND), and 10 patients (all bilateral) who underwent lateral (LND) neck dissection for supraglottic larynx carcinoma. Those with a history of myopathy, neuropathy, recurrent disease, or previous radiotherapy were excluded. Functions of the SAN were evaluated with EMG after at least 12 months postoperatively. The results were assessed in four groups as normal functions, or neurogenic deficit of mild, moderate, or severe degree.
Neurogenic deficits were found in the sternocleidomastoid muscle in eight necks (53.3%) and in the trapezius muscle in seven necks (46.6%) in the FND group. However, only two necks (10%) exhibited neurogenic deficits affecting both muscles in the LBD group. Comparison between the two groups showed a significant difference in terms of SAN functions (p<0.05).
Compared to FND, LND is associated with significantly less neurogenic damage secondary to SAN dissection.
本研究旨在确定声门上喉癌N0患者在择期功能性(II - V级)和侧颈清扫术(II - IV级)后副神经(SAN)的肌电图表现。
本研究纳入10例接受功能性颈清扫术(FND)的患者(5例双侧手术)以及10例接受侧颈清扫术(LND)的声门上喉癌患者(均为双侧手术)。排除有肌病、神经病、复发性疾病或既往放疗史的患者。术后至少12个月用肌电图评估SAN的功能。结果分为四组,即功能正常、轻度、中度或重度神经源性缺损。
在FND组中,8个术侧(53.3%)的胸锁乳突肌出现神经源性缺损,7个术侧(46.6%)的斜方肌出现神经源性缺损。然而,在LND组中,只有2个术侧(10%)出现影响两块肌肉的神经源性缺损。两组之间在SAN功能方面存在显著差异(p<0.05)。
与FND相比,LND继发于SAN解剖的神经源性损伤明显较少。