[Surgical anatomy and preservation of the accessory nerve in radical functional neck dissection].
OBJECTIVE
The surgical anatomy and preservation of the accessory nerve in radical functional neck dissection were studied.


METHODS
Thirty-three cN(0) patients with oral cancers were entered into the study. Radical functional neck dissection were performed and the relations between the accessory nerve and its surrounding structures were recorded.


RESULTS
The accessory nerve going through or beneath the sternocleidomastoid muscle occurred in 82% (27/33) and 18% (6/33) of the patients respectively. Communicating branches between the accessory and the cervical nerves were found in 85% (28/33). There was 2 to 3 cm of the accessory nerve paralleled to the anterior border of the trapezius muscle before it entered the muscle in 70% (23/33). The dissection of the nerve needed 20 to 30 minutes. Twenty-seven percent of the patients had pathologically proved lymph node metastases.


CONCLUSIONS
Looking for accessory nerve under the upper portion of the sternocleidomastoid muscle and above the middle point of the muscle posterior border is simple and safe. The point of the great auricular nerve going out the muscle is an important indicator for finding the accessory nerve.
Guo
Chuan-bin
CB
Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing 100081, China.
Zhang
Ye
Y
Zhang
Lei
L
Zou
Li-dong
LD
D000055:Accessory Nerve / Q000473:pathology / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009334:Neck Muscles / Q000294:innervation