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The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection

  • Head and Neck
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Abstract

Intraoperative monitoring of the cranial nerve XI (CN XI) may decrease shoulder disability following modified radical neck dissection. Prospective study was designed comparing results of Constant Shoulder Score (CSS), Shoulder Pain and Disability Index (SPADI) and EMG score of the trapezius muscle (mT) before and after surgery. One side of the neck was monitored during surgery with intraoperative nerve monitor. EMG scores of the mT 6 months postoperatively were statistically better on monitored as compared to the non-monitored side of the neck (p = 0.041), while the differences of the CSS and SPADI were not statistically significant. Patients with better EMG scores of the mT at 6 weeks recuperated better and with smaller decrease of the CSS. Intraoperative monitoring is beneficial at the beginning of the surgeon’s learning curve and in the process of familiarizing with anatomical variation of the CN XI.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University Medical Center Maribor, Maribor, Slovenia

    Boštjan Lanišnik & Primož Levart

  2. Department of Neurology, University Medical Center Maribor, Maribor, Slovenia

    Lidija Žitnik

  3. University Clinic of Otolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia

    Miha Žargi

  4. Institute of Clinical Neurophysiology, University Medical Center Ljubljana, Ljubljana, Slovenia

    Zoran Rodi

Authors
  1. Boštjan Lanišnik
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  2. Lidija Žitnik
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  3. Primož Levart
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  4. Miha Žargi
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  5. Zoran Rodi
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Corresponding author

Correspondence to Boštjan Lanišnik.

Ethics declarations

Bostjan Lanisnik, MD, PhD, Primoz Levart, MD, Lidija Zitnk, MD, Miha Zargi, MD, PhD and Zoran Rodi, MD, PhD declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lanišnik, B., Žitnik, L., Levart, P. et al. The impact on post-operative shoulder function of intraoperative nerve monitoring of cranial nerve XI during modified radical neck dissection. Eur Arch Otorhinolaryngol 273, 4445–4451 (2016). https://doi.org/10.1007/s00405-016-4096-0

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  • DOI: https://doi.org/10.1007/s00405-016-4096-0

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