颈部解剖术中副神经损伤的电生理分析
Electrophysiologic analysis of injury to cranial nerve XI during neck dissection.
作者信息
Lanisnik Bostjan, Zargi Miha, Rodi Zoran
机构信息
Department of ENT-Head and Neck Surgery, University Medical Center, Maribor, Slovenia.
University Clinic for ENT and Cervicofacial Surgery, University Medical Center, Ljubljana, Slovenia.
出版信息
Head Neck. 2016 Apr;38 Suppl 1:E372-6. doi: 10.1002/hed.24002. Epub 2015 Jun 26.
BACKGROUND
Despite preservation of the accessory nerve, a considerable number of patients report partial nerve damage after modified radical neck dissection (MRND) and selective neck dissection.
METHODS
Accessory nerve branches for the trapezius muscle were stimulated during neck dissection, and the M wave amplitude was measured during distinct surgical phases.
RESULTS
The accessory nerve was mapped in 20 patients. The M wave recordings indicated that major nerve damage occurred during dissection at levels IIa and IIb in the most proximal segment of the nerve. The M waves evoked from this nerve segment decreased significantly during surgery (analysis of variance; p = .001).
CONCLUSION
The most significant intraoperative injury to the accessory nerve during neck dissection occurs at anatomic nerve levels IIa and IIb. © 2015 Wiley Periodicals, Inc. Head Neck 38: E372-E376, 2016.
背景
尽管保留了副神经，但仍有相当数量的患者在改良根治性颈清扫术（MRND）和选择性颈清扫术后报告有部分神经损伤。
方法
在颈清扫术中刺激支配斜方肌的副神经分支，并在不同手术阶段测量M波振幅。
结果
对20例患者的副神经进行了定位。M波记录表明，在神经最近端的Ⅱa和Ⅱb水平进行清扫时发生了主要神经损伤。该神经节段诱发的M波在手术期间显著降低（方差分析；p = 0.001）。
结论
颈清扫术中副神经最严重的术中损伤发生在解剖学神经水平Ⅱa和Ⅱb。©2015威利期刊公司。《头颈》38: E372 - E376，2016年。
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