神经生理学图谱定位颈部副神经的三种解剖模式。
Identification of three anatomical patterns of the spinal accessory nerve in the neck by neurophysiological mapping.
机构信息
Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Medical Center Maribor, Slovenia.
Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Slovenia.
出版信息
Radiol Oncol. 2014 Nov 5;48(4):387-92. doi: 10.2478/raon-2013-0069. eCollection 2014 Dec.
BACKGROUND
In spite of preservation of the accessory nerve there is still considerable proportion of patients with partial nerve damage during modified radical neck dissection (MRND).
METHODS
The nerve was identified during the surgery and its branches for the trapezius muscle mapped with nerve monitor.
RESULTS
The accessory nerve was mapped during 74 hemineck dissections and three patterns were identified. In type 1 nerve exits at the posterior end of the sternocleidomastoid muscle (SCm) and then it enters the level V (66%). In type 2 the nerve for trapezius muscle branches off before entering the SCm (22%). In type 3 the nerve exits at the posterior part of the SCm and it joins to the cervical plexus (12%). The nerve than exits this junction more medially as a single trapezius branch.
CONCLUSIONS
The description of three anatomical patterns in level II and V could help preserving the trapezius branch during MRND.
背景
尽管在改良根治性颈清扫术中保留了副神经，但仍有相当一部分患者存在部分神经损伤。
方法
术中识别副神经，并使用神经监测仪对其支配斜方肌的分支进行定位。
结果
在 74 例半颈清扫术中对副神经进行了定位，发现了三种类型。在 1 型中，副神经在胸锁乳突肌（SCM）后端离开，然后进入 V 水平（66%）。在 2 型中，副神经在进入 SCM 之前分出支配斜方肌的分支（22%）。在 3 型中，副神经在 SCM 的后部分支离开，然后与颈丛融合（12%）。然后，副神经在这个交界处更靠内侧作为一个单一的斜方肌分支离开。
结论
在 II 水平和 V 水平描述三种解剖模式有助于在改良根治性颈清扫术中保留斜方肌分支。
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