Schuller D E, Platz C E, Krause C J
Laryngoscope. 1978 Mar;88(3):439-50. doi: 10.1288/00005537-197803000-00008.
The traditional radical neck dissection involves excision of the spinal accessory nerve en bloc with the soft tissue of the posterior triangle in an effort ot remove completely all node-bearing tissue. The resultant decrease in range of motion of the involved extremity and subsequent pain have prompted some surgeons to seek alternatives. The purpose of this study is to review prospectively radical neck specimens with the specific intent of evaluating the frequency of metastatic involvement of the spinal accessory lymph nodes with head and neck malignancies. Fifty neck specimens were studied and the frequency of cancerous involvement of the spinal accessory nodes was not found to be significantly different from nodal involvement of the entire neck specimen. The location of accessory nerve involvement was predominantly in the proximal portion which is not within the posterior triangle. The results are further evaluated with the subsequent conclusion that preservation of the spinal accessory nerve cannot be justified on the basis of infrequent involvement with metastatic lymph nodes.
传统的根治性颈清扫术包括将副神经与后三角的软组织整块切除，以彻底清除所有含淋巴结的组织。由此导致的受累肢体活动范围减小及随后出现的疼痛促使一些外科医生寻求其他方法。本研究的目的是前瞻性地回顾根治性颈标本，特别旨在评估头颈部恶性肿瘤时副神经淋巴结转移受累的频率。研究了50个颈部标本，发现副神经淋巴结癌性受累的频率与整个颈部标本的淋巴结受累情况无显著差异。副神经受累的位置主要在近端部分，该部分不在后三角内。对结果进行了进一步评估，随后得出结论：基于转移性淋巴结受累不常见而保留副神经是不合理的。
