Nerve transfer in brachial plexus injuries is a well established procedure to restore primordial functions: for example, transfer of the musculocutaneous nerve to the biceps brachialis for restore elbow flexion (Oberlin et al., 1994), and transfer of the accessory nerve
to the suprascapular nerve to restore abduction of the shoulder (Chuang, 1995).
The patient underwent en bloc resection of the mass, with preservation of the brachial plexus, subclavian vessels, and spinal accessory nerve
. The clavicula required an osteotomy, which was fixated with a titanium plate and lock screws.
Nineteen cases showed definite decrements in LF-RNS tests in trapezius, while no abnormalities were found in the electromyography and neurological examination of the sternocleidomastoid muscle, supplied by the accessory nerve
A tracheostomy below the thyroid isthmus and bilateral neck dissection, preserving the spinal accessory nerve
, internal jugular vein and sternocleidomastoid muscle, were performed (Figures 3 and 4).
The most important structure to be attended during the dissection of the flap is the accessory nerve
which passes through it.
We present the case of a 25-year-old patient with a right scapula osteochondroma causing an accessory nerve
A major complication associated with this surgery constitutes the injury to the spinal accessory nerve
in addition to injury to the great vessels and lymphatic vessels .
In 1972, Kotani11 used the spinal accessory nerve
, for the first time, as a donor motor nerve for nerve transfer in patients with brachial plexus injury.
The spine portion of the accessory nerve
(AN) is innervated and its sensory branches are derived from the ventral rami of C3 and C4.
He also talked about safe control of lymph vessels and preserving the spinal accessory nerve
. He also referred to the European Guidelines and pointed out that prophylactic LND control was disputed issue.
The findings on repetitive stimulation studies of the accessory nerve
were also normal.
The sigmoid sinus, inferior petrosal sinus, meningeal branches of occipital and ascending pharyngeal arteries, glossopharyngeal nerve, vagus nerve and accessory nerve
with their ganglia traverse the foramen.