Spinal Accessory Nerve Injury and Reconstruction - Case Report and Literature Review

頸部副神經之受損及重建－病例報告

柯安達(An-Ta Ko) ； 戴浩志(Hao-Chih Tai) ； 謝榮賢(Jung-Hsien Hsieh)

《臺灣整形外科醫學會雜誌》 25卷3期 (2016/09) Pp. 227-234

摘要

背景：副神經(Spinal accessory nerve)從第十一對腦神經延伸支配胸鎖乳突肌及斜方肌的運動，因此當副神經受損時，肩部上提及上臂外展的動作啟動會受到影響。目的及目標：描述副神經受損對病患造成的影響以及及時進行頸部探查修復副神經可改善病人運動功能及改善生活品質。材料及方法：我們報告一位四十六歲的女性，她是一名左側舌癌的患者，在接受部分舌切除及左側改良式頸部淋巴切除後，她抱怨有左肩疼痛及左上肢無力，無法將左手上舉。結果：在門診追蹤經過神經傳導檢查及肌電圖檢查後，疑似為頸部副神經受損，安排了左頸探查進行副神經修復手術，病人的疼痛獲得了改善並且上臂上舉及外展的動作也有明顯的進步。結論：頸部副神經受損是改良式頸部淋巴切除的併發症之一，如果能及時探查進行神經修復，病人可以回復良好的運動功能。

並列摘要

Background: Spinal accessory nerve is the eleventh cranial nerve innervating the sternocleidomastoid and trapezius muscles. The initiation of shoulder elevation and abduction of the arm are affected while spinal accessory nerve is injured. Aim and Objective: This study aimed to describe the benefit of the nerve repair, which may affect the functional outcome and quality of life of the patient. Material and Methods: We report a case of a 46 years old lady who was a victim of left tongue cancer. She received partial glossectomy and left modified radical neck dissection at our ENT department. After the surgery left shoulder pain and difficulty in elevation of left upper extremity were complained. Result: Spinal accessory nerve injury was impressed after serial study during the follow up. Left neck exploration and spinal accessory nerve repair was done and the result was excellent. The patient regained the movement of arm abduction and the patient was satisfied with the outcome. Conclusion: Spinal accessory injury is one of the complications of modified radical neck dissection. Neck exploration and nerve repair could achieve good function recovery.

並列關鍵字

spinal accessory nerve ； neck dissection ； nerve repair