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Spinal Accessory Nerve Monitoring in Head and Neck Surgery

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Intraoperative Cranial Nerve Monitoring in Otolaryngology-Head and Neck Surgery

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Abstract

The spinal accessory nerve (SAN) is a vital structure encountered in many surgeries of the head and neck. The anatomy of the SAN is complex, and identification intraoperatively is key in preventing injury. Compromise of the SAN leads to an array of findings known as postoperative shoulder syndrome, which has a significant impact on patients’ quality of life and contributes to a significant amount of malpractice litigations. Surgeries where the SAN is most at risk include neck dissection, surgery of the posterior triangle such as lymph node biopsies, and lateral skull base surgery. While the frequency of postoperative shoulder syndrome has been mitigated by the trend toward SAN-sparing surgeries in head and neck cancer, it remains a worrisome complication. Intraoperative nerve monitoring is widely used in various head and neck surgeries and has more recently been applied to the SAN. Literature to support the use is variable and relatively limited.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA

    Nicole Molin & Jeffrey C. Liu

  2. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Jeffrey C. Liu

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  1. Nicole Molin
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  2. Jeffrey C. Liu
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Correspondence to Nicole Molin .

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Editors and Affiliations

  1. Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA

    Joseph Scharpf

  2. Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Gregory W. Randolph

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Molin, N., Liu, J.C. (2022). Spinal Accessory Nerve Monitoring in Head and Neck Surgery. In: Scharpf, J., Randolph, G.W. (eds) Intraoperative Cranial Nerve Monitoring in Otolaryngology-Head and Neck Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-84916-0_17

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  • DOI: https://doi.org/10.1007/978-3-030-84916-0_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84915-3

  • Online ISBN: 978-3-030-84916-0

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