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2016, Number 2

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Acta Med 2016; 14 (2)

Spinal accessory nerve injury to cervical lymphadenectomy

Domínguez GLG, Arellano AG, Alcocer MJL, Domínguez CLG
Full text How to cite this article

Language: Spanish
References: 10
Page: 104-107
PDF size: 150.10 Kb.


Key words:

Spinal accessory nerve injury, trapezius palsy.

ABSTRACT

Introduction: Injury to the spinal nerve causes paralysis of the trapezius muscle, the main stabilizer of the scapula contributing in flexion, rotation and abduction movements of the shoulder. Its course is superficial in the posterior triangle of the neck with susceptibility to injury in the dissection of the region, the most common cause of paralysis of the trapezius. Presentation of the case: Female of 27 years who attends rehabilitation for diagnosis and looking for to improve the function of the left upper limb. Such condition began 11 months earlier, when subjected to total thyroidectomy and cervical lymphadenectomy, after surgery presents impossibility to flexion and abduction of the left shoulder more than 60 degrees, clinical diagnosis is spinal accessory nerve injury, confirmed by electromyography and rate of conduction. Because the time of evolution and type of previous surgery, Eden-Lange surgery for correction and improvement in function is proposed. Conclusion: If lesion is detected immediatly, nerve reconstruction must be made. When the time after injury is greater than one year, the procedure of Eden and Lange with muscle transpositions applies, as it corrects the deformity and improves functionality.


REFERENCES

  1. Shaw JP. A history of the enumeration of the cranial nerves by European and British anatomists from the time of Galen to 1895, with comments on nomenclature. Clinical Anatomy. 1992; 5 (6): 466-484.

  2. Duchenne de Boulogne. De l’ectrisation localisse et de son application a la physiologie, a la pathologie et a la therapeitique. Paris: Chez-Bailliere; 1855. pp 443-448.

  3. Prim MP, De Diego JI, Verdaguer JM et al. Neurological complications following functional neck dissection. Eur Arch Otorhinolaryngol. 2006; 263 (5): 473-476.

  4. Eden R. Zur Behandlung der Trapeziuslähmung mittelst Muselplastik. Deutsche Zeitschr Chir. 1924; 184: 387-397.

  5. Lange M. Die Behandlung der irreparablen Trapeziuslähmung. Langenbecks Arch Klin Chir. 1951; 270 (5): 437-439.

  6. Kelley MJ, Kane TE, Leggin BG. Spinal accessory nerve palsy: associated signs and symptoms. J Orthop Sports Phys Ther. 2008; 38 (2): 78-86.

  7. Tsuji T, Tanuma A, Onitsuka T et al. Electromyographic findings after different selective neck dissections. Laryngoscope. 2007; 117 (2): 319-322.

  8. Kim DH, Cho YJ, Tiel RL et al. Surgical outcomes of 111 spinal accessory nerve injuries. Neurosurgery. 2003; 53 (5): 1106-1112.

  9. Akgun K, Aktas I, Uluc K. Conservative treatment for late-diagnosed spinal accessory nerve injury. Am J Phys Med Rehabil. 2008; 87 (12): 1015-1021.

  10. Romero J, Gerber C. Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure. J Bone Joint Sur Br. 2003; 85 (8): 1141-1145.




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Acta Med. 2016;14