Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-27T00:34:17.729Z Has data issue: false hasContentIssue false
  • English
  • Français

Intra-operative monitoring of the spinal accessory nerve: a systematic review

Published online by Cambridge University Press:  29 August 2014

A C McGarvey ,
G R Hoffman ,
P G Osmotherly  and
P E Chiarelli
A C McGarvey*
Affiliation:
Physiotherapy Department, Calvary Mater Newcastle Hospital, NSW, Australia School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
G R Hoffman
Affiliation:
School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, Australia Department of Surgery, John Hunter Hospital, New Lambton, NSW, Australia
P G Osmotherly
Affiliation:
School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
P E Chiarelli
Affiliation:
School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
*
Address for correspondence: Aoife C McGarvey, Physiotherapy department, Calvary Mater Newcastle Hospital, Edith St, Waratah, NSW 2298, Australia E-mail: Aoife.McGarvey@calvarymater.org.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate evidence that intra-operative nerve monitoring of the spinal accessory nerve affects the prevalence of post-operative shoulder morbidity and predicts functional outcome.

Methods:

A search of the Medline, Scopus and Cochrane databases from 1995 to October 2012 was undertaken, using the search terms ‘monitoring, intra-operative’ and ‘accessory nerve’. Articles were included if they pertained to intra-operative accessory nerve monitoring undertaken during neck dissection surgery and included a functional shoulder outcome measure. Further relevant articles were obtained by screening the reference lists of retrieved articles.

Results:

Only three articles met the inclusion criteria of the review. Two of these included studies suggesting that intra-operative nerve monitoring shows greater specificity than sensitivity in predicting post-operative shoulder dysfunction. Only one study, with a small sample size, assessed intra-operative nerve monitoring in neck dissection patients.

Conclusion:

It is unclear whether intra-operative nerve monitoring is a useful tool for reducing the prevalence of accessory nerve injury and predicting post-operative functional shoulder outcome in patients undergoing neck dissection. Larger, randomised studies are required to determine whether such monitoring is a valuable surgical adjunct.

Keywords

Neck DissectionAccessory NerveIntraoperative Neurophysiological Monitoring
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 746 - 751
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Chaplin, JM, Morton, RP. A prospective, longitudinal study of pain in head and neck cancer patients. Head Neck 1999;21:531–73.0.CO;2-M>CrossRefGoogle ScholarPubMed
2Stuiver, MM, van Wilgen, CP, de Boer, EM, De Goede, CJ, Koolstra, M, van Opzeeland, A et al. Impact of shoulder complaints after neck dissection on shoulder disability and quality of life. Otolaryngol Head Neck Surg 2008;139:32–9CrossRefGoogle ScholarPubMed
3Terrell, J, Welsh, D, Bradford, C, Chepeha, D, Esclamado, R, Hogikyan, N et al. Pain, quality of life, and spinal accessory nerve status after neck dissection. Laryngoscope 2000;110:620–6CrossRefGoogle ScholarPubMed
4van Wilgen, CP, Dijkstra, PU, van der Laan, AM, Plukker, JT, Roodenburg, JL. Shoulder complaints after nerve sparing neck dissections. Int J Oral Maxillofac Surg 2004;33:253–7CrossRefGoogle ScholarPubMed
5McGarvey, AC, Osmotherly, PG, Hoffman, GR, Chiarelli, PE. Impact of neck dissection on scapular muscle function: A case-controlled EMG study. Arch Phys Med Rehabil 2013;94:113–19Google Scholar
6Harner, S, Daube, J, Ebersold, M. Electrophysiologic monitoring of neural function during temporal bone surgery. Laryngoscope 1986;96:65–9Google Scholar
7Harper, C. Intraoperative cranial nerve monitoring. Muscle Nerve 2004;29:339–51Google Scholar
8Fukuda, M, Oishi, M, Hiraishi, T, Saito, A, Fujii, Y. Intraoperative facial nerve motor evoked potential monitoring during skull base surgery predicts long-term facial nerve function outcomes. Neurol Res 2011;33:578–82Google Scholar
9Grosheva, M, Klussman, J, Grimminger, C, Wittekindt, C, Beutner, D, Pantel, M et al. Electromyographic facial nerve monitoring during parotidectomy for benign lesions does not improve the outcome of postoperative facial nerve function: a prospective two-center trial. Laryngoscope 2009;119:2299–305CrossRefGoogle Scholar
10Shindo, M. Incidence of vocal cord paralysis with and without recurrent laryngeal nerve monitoring during thyroidectomy. Arch Otolaryngol Head Neck Surg 2007;133:481–5Google Scholar
11Witt, R, Gillis, T, Pratt, R. Spinal accessory nerve monitoring with clinical outcome measures. Ear Nose Throat J 2006;85:540–4Google Scholar
12Lefaucheur, J, Neves, D, Vial, C. Electrophysiological monitoring of cranial motor nerves (V, VII, IX, X, XI, XII) [in French]. Neurochirurgie 2009;55:136–41Google Scholar
13Schipper, J, Ridder, G, Arapakis, I, Gellrich, N, Spetzger, U, Maier, W. Neurophysiologic intraoperative monitoring to preserve cranial nerve function in base of skull surgery [in German]. HNO 2004;52:897–907Google Scholar
14Kwiek, S, Bazowski, P, Luszawski, J, Namyslowski, G, Morawski, K, Lisowska, G et al. Monitoring of neurophysiologic modalities during surgery for cerebellopontine angle tumors. Personal experiments [in Polish]. Otolaryngol Pol 2001;55:85–90Google Scholar
15Zhang, J, Yang, C, Liang, W. Intraoperative cranial nerves monitoring under partial neuromuscular relaxation during cerebellopontine angle tumor resection [in Chinese]. Zhonghua Yi Xue Za Zhi 2008;88:1481–4Google Scholar
16Zhao, X, Wang, Z, Ji, Y, Wang, C, Yu, R, Ding, X et al. Long-term facial nerve function evaluation following surgery for large acoustic neuromas via retrosigmoid transmeatal approach. Acta Neurochir (Wien) 2010;152:1647–52Google Scholar
17Bu, B, Zhou, D, Xu, B, Yu, X, Zhang, Y, Wei, S. Spontaneous and evoked facial nerve muscle electromyogram in monitoring nervous function in acoustic neuroma surgery and nervous prognosis: A character analysis in 120 cases [in Chinese]. Zhongguo lin chuang kang fu 2006;10:162–5Google Scholar
18Leppanen, R. Intraoperative monitoring of trapezius function. Spine (Phila Pa 1976) 2003;3:248Google Scholar
19Sugiyama, K, Yokoyama, T, Ryu, H, Namba, H. Intraoperative monitoring methods for the lower cranial nerves [in Japanese]. Nōshinkei geka jānaru 2001;10:330–8Google Scholar
20Beck, D, Maves, M, Stith, J. Spinal accessory nerve preservation. Laryngoscope 2009;101:1386CrossRefGoogle Scholar
21Friedenberg, S, Zimprich, T, Harper, M. The natural history of long thoracic and spinal accessory neuropathies. Muscle Nerve 2002;25:535–9CrossRefGoogle ScholarPubMed
22Orhan, KS, Demirel, T, Baslo, B, Orhan, E, Yucel, EA, Guldiken, Y et al. Spinal accessory nerve function after neck dissections. J Laryngol Otol 2007;121:44–8Google Scholar
23Schlake, H, Goldbrunner, R, Milewski, C, Krauss, J, Trautner, H, Behr, R et al. Intra-operative electromyographic monitoring of the lower cranial motor nerves (LCN IX-XII) in skull base surgery. Clin Neurol Neurosurg 2001;103:72–82Google Scholar
24Witt, R, Rejto, L. Spinal accessory nerve monitoring in selective and modified neck dissection. Laryngoscope 2007;117:776–80Google Scholar
25Dillon, F. Electromyographic neuromonitoring in otolaryngology-head and neck surgery. Anesthesiology 2010;28:423–42Google Scholar
26Mischler, T, Smith, E. Technical aspects of intraoperative monitoring of lower cranial nerve function. Skull Base Surg 1995;5:245–50CrossRefGoogle Scholar
27Shils, J, Martin, C, Deletis, V. Intraoperative monitoring for surgeries at the jugular foramen. Operat Tech Neurosurg 2005;8:42–9Google Scholar
28Skinner, S. Neurophysiologic monitoring of the spinal accessory nerve, hypoglossal nerve, and the spinomedullary region. J Clin Neurophysiol 2011;28:587–98Google Scholar
29Laughlin, R, Spinner, R, Daube, J. Electrophysiological testing of spinal accessory nerve in suspected cases of nerve transection. Muscle Nerve 2011;44:715–19Google Scholar
30Donner, T, Kline, D. Extracranial spinal accessory nerve injury. Neurosurgery 1993;32:907–11CrossRefGoogle ScholarPubMed
31Soo, K-C, Strong, EW, Spiro, RH, Shah, JP, Nori, S, Green, RF. Innervation of the trapezius muscle by the intra-operative measurement of motor action potentials. Head Neck 1993;15:216–21Google Scholar
32Sekiya, T, Hatayama, T, Akasaka, K, Suzuki, S. Intraoperative monitoring of the lower cranial nerves during skull base surgery: Evoked myographic technique [in Japanese]. No Shinkei Geka 1995;23:491–6Google Scholar
33Karlikaya, G, Citci, B, Guclu, B, Ture, H, Bingol, C. Spinal accessory nerve monitoring in posterior fossa surgery. J Clin Neurophysiol 2008;25:346–50Google Scholar
34Midwinter, K, Willatt, D. Accessory nerve monitoring and stimulation during neck surgery. J Laryngol Otol 2002;116:272–4Google Scholar
35Topsakal, C, Al-Mefty, O, Bulsara, K, Williford, V. Intraoperative monitoring of lower cranial nerves in skull base surgery: technical report and review of 123 monitored cases. Neurosurg Rev 2008;31:45–53Google Scholar
36Witt, R. Facial nerve monitoring in parotid surgery: The standard of care. Otolaryngol Head Neck Surg 1998;119:468–70Google Scholar
37Higgins, T, Gupta, R, Ketcham, A, Sataloff, R, Wadsworth, J, Sinacori, J. Recurrent laryngeal nerve monitoring versus identification alone on post-thyroidectomy true vocal cord palsy: a meta-analysis. Laryngoscope 2011;121:1009–17CrossRefGoogle ScholarPubMed
38Barczynski, M, Konturek, A, Cichori, S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 2009;96:240–6Google Scholar
39Gavilán, J, Herranz, J, Martín, L. Functional neck dissection: the Latin approach. Operative techniques in otolaryngology—head and neck surgery 2004;15:168–75Google Scholar
40Taylor, J, Terrell, J, Ronis, D, Fowler, K, Bishop, C, Lambert, M et al. Disability in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:764–9Google Scholar
41Heald, SL, Riddle, DL, Lamb, RL. The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure. Phys Ther 1997;77:1079–89Google Scholar
42Schmitt, JS, Di Fabio, RP. Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria. J Clin Epidemiol 2004;57:1008–18Google Scholar