Department of Otolaryngology-Head and Neck Surgery, University of Uludag School of Medicine, Bursa/Turkey.
Head Neck. 2009 Nov;31(11):1496-501. doi: 10.1002/hed.21112.
The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b-preserving selective neck dissection.
Forty-one necks of 30 patients with laryngeal cancer who underwent unilateral or bilateral level 2b-preserving neck dissections, between February 2003 and July 2005, were evaluated. Neck and shoulder movements and muscle strengths were examined and electroneuromyography (ENMG) was performed preoperatively at the postoperative 21st day and 6th month. Pathological anatomical findings at the postoperative 6th month were also evaluated.
All shoulder movements and muscle strengths were preserved. Neck extension, rotation movements, and flexion strengths were restricted. ENMG values were affected moderately in the early postoperative period and improved slightly in the late postoperative period. None of the patients developed shoulder syndrome or adhesive capsulitis.
Preserving level 2b during selective neck dissection decreases trauma to the accessory nerve and improves functional results.
本前瞻性研究旨在评估副神经功能与 2b 水平保留性选择性颈清扫术之间的关系。
2003 年 2 月至 2005 年 7 月,对 30 例喉癌患者的 41 侧行单侧或双侧 2b 水平保留性颈清扫术的颈部进行评估。术前、术后第 21 天和第 6 个月检查颈肩运动和肌肉力量,并进行肌电图(ENMG)检查。术后第 6 个月还评估了病理解剖学发现。
所有肩运动和肌肉力量均保留。颈部伸展、旋转运动和屈曲力量受限。ENMG 值在术后早期受中度影响,在术后晚期略有改善。无患者发生肩综合征或粘连性囊炎。
选择性颈清扫术中保留 2b 水平可减少对副神经的损伤,改善功能结果。