Skip to main content
SpringerLink
Log in

Neural Complications

  • Chapter
  • First Online:
Complications in Neck Dissection

  • 371 Accesses

Abstract

Within the construct of modified radical neck dissection and selective neck dissection, the reported incidence of nerve-related complications is low. Even by current surgical standards, the best treatment is to avoid nerve injuries in the first place. The most reliable way to achieve this is through the oncologic surgeons’ absolute mastery of anatomy. The objectives of this chapter are as follows: to discuss the various nerve injuries that may be encountered, review pertinent anatomy, highlight select statistics of neurological complications, discuss functional consequences of nerve injury, explore various surgical techniques, and to discuss different management considerations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Talmi YP. Minimizing complications in neck dissection. J Laryngol Otol. 1999;113(2):101–13.

    Article  CAS  Google Scholar 

  2. Batstone MD, Scott B, Lowe D, Rogers SN. Marginal mandibular nerve injury during neck dissection and its impact on patient perception of appearance. Head Neck. 2009;31(5):673–8.

    Article  Google Scholar 

  3. Morlandt ABHJ. Surgical management of the neck. In: Atlas of operative oral and maxillofacial surgery. John Wiley & Sons, Inc. editorial offices in Ames, Iowa; West Sussex, UK; Oxford, UK. 2015. p. 424–30.

    Google Scholar 

  4. Bagheri SC, Bell RB, Khan HA, Duncan L, Dolan J, Sprehe C, et al. Current therapy in oral and maxillofacial surgery. St. Louis: Elsevier Saunders; 2012.

    Google Scholar 

  5. Eibling DE. Neck dissections. In: Operative otolaryngology: head and neck surgery, vol. 1; Saunders United States. 1997. p. 676–718.

    Google Scholar 

  6. Prim MP, De Diego JI, Verdaguer JM, Sastre N, Rabanal I. Neurological complications following functional neck dissection. Eur Arch Otorhinolaryngol. 2006;263(5):473–6.

    Article  CAS  Google Scholar 

  7. Dedivitis RA, Guimaraes AV, Pfuetzenreiter EG, Jr., Castro MA. [Neck dissection complications]. Braz J Otorhinolaryngol. 2011;77(1):65–9.

    Google Scholar 

  8. Moller MN, Sorensen CH. Risk of marginal mandibular nerve injury in neck dissection. Eur Arch Otorhinolaryngol. 2012;269(2):601–5.

    Article  Google Scholar 

  9. Tirelli G, Bergamini PR, Scardoni A, Gatto A, Boscolo Nata F, Marcuzzo AV. Intraoperative monitoring of marginal mandibular nerve during neck dissection. Head Neck. 2018;40(5):1016–23.

    Article  Google Scholar 

  10. Murthy SP, Paderno A, Balasubramanian D. Management of the marginal mandibular nerve during and after neck dissection. Curr Opin Otolaryngol Head Neck Surg. 2019;27(2):104–9.

    Article  Google Scholar 

  11. Bater MC, Dufty J, Brennan PA. High division of the accessory nerve: a rare anatomical variation as a possible pitfall during neck dissection surgery. J Cranio-Maxillofac Surg. 2005;33(5):340–1.

    Article  Google Scholar 

  12. Witt RL, Rejto L. Spinal accessory nerve monitoring in selective and modified neck dissection. Laryngoscope. 2007;117(5):776–80.

    Article  Google Scholar 

  13. Karaman M, Tek A, Cl U, Akduman D, Bi laç Ö. Effect of functional neck dissection and postoperative radiotherapy on the spinal accessory nerve. Acta Otolaryngol. 2009;129(8):872–80.

    Article  Google Scholar 

  14. Barber B, Seikaly H, Ming Chan K, Beaudry R, Rychlik S, Olson J, et al. Intraoperative brief electrical stimulation of the spinal accessory nerve (BEST SPIN) for prevention of shoulder dysfunction after oncologic neck dissection: a double-blinded, randomized controlled trial. J Otolaryngol Head Neck Surg. 2018;47(1):7–10.

    Article  Google Scholar 

  15. McGarvey AC, Chiarelli PE, Osmotherly PG, Hoffman GR, Eisele DW. Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: a literature review. Head Neck. 2011;33(2):274–80.

    Article  Google Scholar 

  16. McGarvey AC, Hoffman GR, Osmotherly PG, Chiarelli PE. Maximizing shoulder function after accessory nerve injury and neck dissection surgery: a multicenter randomized controlled trial. Head Neck. 2015;37(7):1022–31.

    Article  Google Scholar 

  17. Salerno G, Cavaliere M, Foglia A, Pellicoro DP, Mottola G, Nardone M, et al. The 11th nerve syndrome in functional neck dissection. Laryngoscope. 2002;112(7):1299–307.

    Article  Google Scholar 

  18. van Wilgen CP, Dijkstra PU, van der Laan BFAM, Plukker JT, Roodenburg JLN. Shoulder complaints after neck dissection; is the spinal accessory nerve involved? Br J Oral Maxillofac Surg. 2003;41(1):7–11.

    Article  Google Scholar 

  19. Mathialagan AMS, Verma RKMSDNBM, Panda NKMSFF. Comparison of spinal accessory dysfunction following neck dissection with harmonic scalpel and electrocautery – a randomized study. Oral Oncol. 2016;61:142–5.

    Article  Google Scholar 

  20. Murphy R, Dziegielewski P, O’Connell D, Seikaly H, Ansari K. The great auricular nerve: an anatomic and surgical study. J Otolaryngol Head Neck Surg. 2012;41(1):S75–S7.

    PubMed  Google Scholar 

  21. Barbour JR, Gontre G, Halpern D. Surgical decompression of the greater auricular nerve: a therapeutic option in neurapraxia following rhytidectomy. Plast Reconstr Surg. 2012;130:41.

    Article  Google Scholar 

  22. Lefkowitz T, Hazani R, Chowdhry S, Elston J, Yaremchuk MJ, Wilhelmi BJ. Anatomical landmarks to avoid injury to the great auricular nerve during rhytidectomy. Aesthet Surg J. 2013;33(1):19–23.

    Article  Google Scholar 

  23. Monteiro MJ, Altman K, Khandwala A. Injury to the brachial plexus in neck dissections. Br J Oral Maxillofac Surg. 2009;48(3):197–8.

    Article  Google Scholar 

  24. Yaddanapudi S, Shah SC. Bilateral phrenic nerve injury after neck dissection: an uncommon cause of respiratory failure. J Laryngol Otol. 1996;110(3):281–3.

    Article  CAS  Google Scholar 

  25. AbuRahma AF, Lim RY. Management of vagus nerve injury after carotid endarterectomy. Surgery. 1996;119(3):245–7.

    Article  CAS  Google Scholar 

  26. Giulea C, Enciu O, Toma EA, Martin S, Fica S, Miron A. Total thyroidectomy for malignancy – is central neck dissection a risk factor for recurrent nerve injury and postoperative hypocalcemia? A tertiary center experience in Romania. Acta Endocrinol. 2019;15(1):80–5.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, University of Rochester – Strong Memorial Hospital, Eastman Institute for Oral Health, Rochester, NY, USA

    Moo Hyun Kim & Antonia Kolokythas

Authors
  1. Moo Hyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonia Kolokythas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moo Hyun Kim .

Editor information

Editors and Affiliations

  1. Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Texas Health Presbyterian Hospital, Dallas, TX, USA

    Thomas Schlieve

  2. Oral and Maxillofacial Surgery Department, Louisiana State University Health sciences center – New Orleans, Our Lady of the Lake Regional Medical center – Baton Rouge, Baton Rouge, LA, USA

    Waleed Zaid

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kim, M.H., Kolokythas, A. (2021). Neural Complications. In: Schlieve, T., Zaid, W. (eds) Complications in Neck Dissection. Springer, Cham. https://doi.org/10.1007/978-3-030-62739-3_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-62739-3_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62738-6

  • Online ISBN: 978-3-030-62739-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation