A technique for preservation of spinal accessory nerve function in radical neck dissection

Abstract

A new technique is described that preserves trapezius muscle function in radical neck surgery while cutting that part of the spinal accessory nerve which courses through the sternocleidomastoid muscle. The technique takes advantage of the little-know fact that, in humans, the trapezius muscle has dual innervation. The C2-3-4 motor root is joined to the distal portion of the spinal accessory nerve to give motor function to the trapezius muscle. This procedure will save shoulder mobility in the majority of patients who undergo radical neck dissection. The technique is accomplished rapidly with the use of the gastrointestinal stapler in the scalene fat pad.