Accessory nerve function after level 2b-preserving selective neck dissection

Abstract

Background. The aim of this prospective study was to evaluate the relationship between accessory nerve functions and level 2b-preserving selective neck dissection.

Methods. Forty-one necks of 30 patients with laryngeal cancer who underwent unilateral or bilateral level 2b-preserving neck dissections, between February 2003 and July 2005, were evaluated. Neck and shoulder movements and muscle strengths were examined and electroneuromyography (ENMG) was performed preoperatively at the postoperative 21st day and 6th month. Pathological anatomical findings at the postoperative 6th month were also evaluated.

Results. All shoulder movements and muscle strengths were preserved. Neck extension, rotation movements, and flexion strengths were restricted. ENMG values were affected moderately in the early postoperative period and improved slightly in the late postoperative period. None of the patients developed shoulder syndrome or adhesive capsulitis.

Conclusion. Preserving level 2b during selective neck dissection decreases trauma to the accessory nerve and improves functional results.