The Experts below are selected from a list of 450 Experts worldwide ranked by ideXlab platform
S. E. Mackinnon - One of the best experts on this subject based on the ideXlab platform.
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Treatment of a proximal Accessory Nerve Injury with Nerve transfer
Laryngoscope, 2004Co-Authors: Christine B. Novak, S. E. MackinnonAbstract:Objective and Hypothesis: This study presents a case report of a patient who sustained an iatrogenic proximal Accessory Nerve Injury that was treated with a medial pectoral to Accessory Nerve transfer. Study Design: Case study. Materials and Methods: Chart of one patient who was treated with a medial pectoral to Accessory Nerve transfer was reviewed. Results: Five months after excision of a branchial cyst that resulted in a very proximal Injury to the Accessory Nerve, this patient underwent a medial pectoral to Accessory Nerve transfer. At final follow-up, 3 years after surgery, the patient had full abduction overhead with some residual shoulder/scapular discomfort and mild scapular winging. Conclusion: The medial pectoral to Accessory Nerve transfer provides a viable surgical option with good reinnervation of the trapezius muscle in patients with a proximal Accessory Nerve Injury where standard Nerve repair or graft techniques are not feasible.
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patient outcome after surgical management of an Accessory Nerve Injury
Otolaryngology-Head and Neck Surgery, 2002Co-Authors: Christine B. Novak, S. E. MackinnonAbstract:OBJECTIVE: This study assessed patient outcome following surgical reconstruction of the Accessory Nerve after an iatrogenic Injury.STUDY DESIGN: A retrospective chart review of 8 patients was performed.RESULTS: There were 3 men and 5 women in the study, and the mean time between Injury and Nerve graft/repair surgery was 5 months. Four injuries were sustained during a lymph node biopsy. Electromyography revealed a complete Accessory Nerve Injury in all cases. In 6 cases, a Nerve graft was required (mean length, 3.6 cm), and in 2 cases, a direct Nerve repair was possible. The trapezius muscle was successfully reinnervated in all cases. In total, full shoulder abduction was achieved in 6 cases; in the remaining 2 cases, the patients achieved shoulder abduction to 90°.CONCLUSION: Functional deficit after Accessory Nerve Injury is significant. Nerve graft/repair reconstruction reliably yields a satisfactory result, providing good scapular rotation and thus good shoulder function.
Louis U Bigliani - One of the best experts on this subject based on the ideXlab platform.
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spinal Accessory Nerve Injury
Clinical Orthopaedics and Related Research, 1999Co-Authors: J. Michael Wiater, Louis U BiglianiAbstract:Injury to the spinal Accessory Nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spinal Accessory Nerve in the posterior cervical triangle makes it susceptible to Injury. Iatrogenic Injury to the Nerve after a surgical procedure is one of the most common causes of trapezius palsy. Dysfunction of the trapezius can be a painful and disabling condition. The shoulder droops as the scapula is translated laterally and rotated downward. Patients present with an asymmetric neckline, a drooping shoulder, winging of the scapula, and weakness of forward elevation. Evaluation should include a complete electrodiagnostic examination. If diagnosed within 1 year of the Injury, microsurgical reconstruction of the Nerve should be considered. Conservative treatment of chronic trapezius paralysis is appropriate for older patients who are sendentary. Active and healthy patients in whom 1 year of conservative treatment has failed are candidates for surgical reconstruction. Studies have shown the Eden-Lange procedure, in which the insertions of the levator scapulae, rhomboideus minor, and rhomboideus major muscles are transferred, relieves pain, corrects deformity, and improves function in patients with irreparable Injury to the spinal Accessory Nerve.
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Spinal Accessory Nerve Injury.
Clinical Orthopaedics and Related Research, 1999Co-Authors: Louis U BiglianiAbstract:Injury to the spinal Accessory Nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spina
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Spinal Accessory Nerve Injury : Neurologic injuries about the shoulder girdle
Clinical Orthopaedics and Related Research, 1999Co-Authors: J. Michael Wiater, Louis U BiglianiAbstract:Injury to the spinal Accessory Nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spinal Accessory Nerve in the posterior cervical triangle makes it susceptible to Injury. Iatrogenic Injury to the Nerve after a surgical procedure is one of the most common causes of trapezius palsy. Dysfunction of the trapezius can be a painful and disabling condition. The shoulder droops as the scapula is translated laterally and rotated downward. Patients present with an asymmetric neckline, a drooping shoulder, winging of the scapula, and weakness of forward elevation. Evaluation should include a complete electrodiagnostic examination. If diagnosed within 1 year of the Injury, microsurgical reconstruction of the Nerve should be considered. Conservative treatment of chronic trapezius paralysis is appropriate for older patients who are sendentary. Active and healthy patients in whom 1 year of conservative treatment has failed are candidates for surgical reconstruction. Studies have shown the Eden-Lange procedure, in which the insertions of the levator scapulae, rhomboideus minor, and rhomboideus major muscles are transferred, relieves pain, corrects deformity, and improves function in patients with irreparable Injury to the spinal Accessory Nerve.
Gary R Hoffman - One of the best experts on this subject based on the ideXlab platform.
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maximizing shoulder function after Accessory Nerve Injury and neck dissection surgery a multicenter randomized controlled trial
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2015Co-Authors: Aoife C Mcgarvey, Gary R Hoffman, Peter G Osmotherly, Pauline ChiarelliAbstract:ABSTRACTBackground.Shoulder pain and dysfunction after neck dissection may result from Injury to the Accessory Nerve. The effect of early physical therapy in the form of intensive scapular strengthening exercises is unknown.Methods.A total of 59 neck dissection participants were prospectively recrui
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Intra-operative monitoring of the spinal Accessory Nerve: a systematic review.
The Journal of laryngology and otology, 2014Co-Authors: Aoife C Mcgarvey, Gary R Hoffman, Peter G Osmotherly, Pauline ChiarelliAbstract: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.
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physiotherapy for Accessory Nerve shoulder dysfunction following neck dissection surgery a literature review
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2011Co-Authors: Aoife C Mcgarvey, Peter G Osmotherly, Pauline Chiarelli, Gary R HoffmanAbstract:Background: Neck dissection is an operation that can result in Accessory Nerve Injury. Accessory Nerve shoulder dysfunction (ANSD) describes the pain and impaired range of motion that may occur following neck dissection. The aim of this review was to establish the level of evidence for the effectiveness of physiotherapy in the postoperative management of ANSD. Methods: A literature search of physiotherapy and ANSD using Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and Cochrane Library databases was undertaken. Results: Physiotherapy has been shown to be well tolerated in this patient group following surgery. However, few studies exist as to the effect of physiotherapy on ANSD. Conclusions: There is a need for research to investigate the effects of early, appropriate physiotherapy on the development of ANSD following neck dissection surgery. Such a study has the potential to improve the functional outcome and quality of life in this patient group, and ultimately to promote best practice guidelines for management. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
Willibald Nagler - One of the best experts on this subject based on the ideXlab platform.
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spinal Accessory Nerve palsy as a cause of pain after whiplash Injury case report
Journal of Pain and Symptom Management, 1998Co-Authors: Mark P Bodack, Richard Tunkel, Steven Marini, Willibald NaglerAbstract:Abstract Spinal Accessory Nerve Injury is most commonly reported following surgery in and around the posterior cervical triangle. Pain, impaired ability to raise the ipsilateral shoulder, and scapular winging on abduction of the arm are the most frequently noted clinical manifestations. We report the case of a collegiate swimmer who developed left-sided neck and shoulder pain secondary to a spinal Accessory Nerve palsy (SANP) after a "whiplash Injury," which we believe to be the first such reported case in the English language literature. We review the clinical manifestations, diagnostic pitfalls, and therapeutic approaches to SANP. A high index of suspicion for SANP following whiplash-type Injury will ensure its earlier detection and treatment and improve the chances of a better functional outcome.
Leandro Pretto Flores - One of the best experts on this subject based on the ideXlab platform.
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Suprascapular Nerve release for treatment of shoulder and periscapular pain following intracranial spinal Accessory Nerve Injury.
Journal of neurosurgery, 2008Co-Authors: Leandro Pretto FloresAbstract:Iatrogenic Injury to the spinal Accessory Nerve is one of the most common causes of trapezius muscle palsy. Dysfunction of this muscle can be a painful and disabling condition because scapular winging may impose traction on the soft tissues of the shoulder region, including the suprascapular Nerve. There are few reports regarding therapeutic options for an intracranial Injury of the Accessory Nerve. However, the surgical release of the suprascapular Nerve at the level of the scapular notch is a promising alternative approach for treatment of shoulder pain in these cases. The author reports on 3 patients presenting with signs and symptoms of unilateral Accessory Nerve Injury following resection of posterior fossa tumors. A posterior approach was used to release the suprascapular Nerve at the level of the scapular notch, transecting the superior transverse scapular ligament. All patients experienced relief of their shoulder and scapular pain following the decompressive surgery. In 1 patient the primary dorsal branch of the C-2 Nerve root was transferred to the extracranial segment of the Accessory Nerve, and in the other 2 patients a tendon transfer (the Eden-Lange procedure) was used. Results from this report show that surgical release of the suprascapular Nerve is an effective treatment for shoulder and periscapular pain in patients who have sustained an unrepairable Injury to the Accessory Nerve.
