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[副脊神经外支术后医源性损伤]

[Postoperative iatrogenic lesions of the external branch of the accessory spinal nerve].

作者信息

Autran J M, Hazan A, Senechaut J P, Peytral C

机构信息

Service d'Oto-Rhino-Laryngologie, CHI de Montfermeil.

出版信息

Ann Otolaryngol Chir Cervicofac. 1988;105(5):339-42.

PMID:3178086
Abstract

Iatrogenic lesions of the spinal nerve are rare and generally occur during cervicotomy for aetiological assessment of adenopathy. The spinal nerve is essentially damaged at two sites: the supraclavicular fossa (where the nerve is very superficial) and in the antero-lateral triangle of the neck (where the nerve approaches the sterno-cleido-mastoid muscle). The lesion of the spinal nerve essentially presents in the form of paralysis of the trapezius; which should be examined systematically postoperatively and at subsequent consultations, as the clinical signs may only develop after a certain latency period. The spinal nerve lesion requires early surgical repair (graft, suture) which gives the best results when it is associated with long-term, patient physiotherapy. Legally, the practitioner is generally condemned due to failure to obtain informed consent, which emphasises the importance of preoperative consultations during which the patients should be warned of the possibility of a lesion to this nerve.

摘要

医源性脊神经损伤很少见,通常发生在为评估腺病病因进行颈切开术期间。脊神经主要在两个部位受损:锁骨上窝(神经非常表浅)和颈部前外侧三角(神经靠近胸锁乳突肌)。脊神经损伤主要表现为斜方肌麻痹;术后及后续会诊时应系统检查,因为临床体征可能在一定潜伏期后才出现。脊神经损伤需要早期手术修复(移植、缝合),与患者长期物理治疗相结合时效果最佳。在法律上,从业者通常因未获得知情同意而受到谴责,这凸显了术前会诊的重要性,在此期间应告知患者该神经有损伤的可能性。

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