Radical Neck Dissection and Permanent Sequelae Associated with Spinal Accessory Nerve Injuries

Abstract

Postoperative sequelae consequent upon radical neck dissection were evaluated in patients with severed spinal accessory nerve and in patients with preserved spinal accessory nerve. Unexpected nerve paresis of varying degree, but of permanent character, occurred in 15 of 35 patients with preserved nerve. In patients with sacrificed nerve the range of active shoulder abduction and the strength of abduction were significantly reduced. Daily shoulder pain at rest and particularly during motion occurred frequently. In patients with preserved but injured nerve, the paresis was incomplete in some cases. Nevertheless pain was not unusual. Of 3 patients with injured nerve, 2 experienced daily shoulder pain and/or a limited abduction capacity of the shoulder. Half of these patients considered themselves socially handicapped.