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The role of intraoperative neuromonitoring in preventing lesions of the spinal accessory nerve during functional neck dissection

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Abstract

Intraoperative neuromonitoring (IONM) in thyroid surgery offers a valid aid to the operator in identifying the recurrent laryngeal nerve and preserving its function. Recently, IONM has also been used in other surgeries, such as spinal accessory nerve dissection, during lymphectomy of the II, III, IV, and V laterocervical lymph nodes. The goal is the preservation of the spinal accessory nerve, whose macroscopic integrity does not always indicate its functionality. A further difficulty is the anatomical variability of its course at the cervical level. The aim of our study is to assess whether the use of the IONM helps to reduce the incidence of transient and permanent paralysis of the spinal accessory nerve, compared to “de visu” identification by the surgeon alone. In our case series, the use of the IONM reduced the incidence of transient paralysis, and no permanent paralysis was recorded. In addition, if the IONM registers a reduction in nerve potential, compared to the baseline value during surgery, it could indicate the need for early rehabilitation treatment, increasing the patients’ chances of regaining function and reducing the costs of prolonged physiotherapy treatment.

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Authors and Affiliations

  1. Dipartimento di Scienze Medico-Chirurgiche e Medicina Traslazionale, Università Sapienza di Roma, Roma, Italy

    Alessandra Cossa, Valentina Sbacco, Elena Belloni, Letizia Corbi, Giuseppe Nigri & Carlo Bellotti

Authors
  1. Alessandra Cossa
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  2. Valentina Sbacco
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  3. Elena Belloni
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  4. Letizia Corbi
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  5. Giuseppe Nigri
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  6. Carlo Bellotti
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Contributions

All authors contributed to the study conception and design. “Conceptualization, A.C. and C.B.; methodology, A.C.; validation, C.B. and G.N.; formal analysis, V.S. and E.B.; investigation, L.C.; resources, A.C. and L.C.; data curation, E.B.; writing—original draft preparation, A.C. and V.S.; writing—review and editing, A.C.,V.S. and E.B.; visualization, V.S.; supervision, C.B. and G.N.; project administration, G.N.

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Correspondence to Alessandra Cossa.

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Cossa, A., Sbacco, V., Belloni, E. et al. The role of intraoperative neuromonitoring in preventing lesions of the spinal accessory nerve during functional neck dissection. Endocrine 81, 134–140 (2023). https://doi.org/10.1007/s12020-023-03324-8

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  • DOI: https://doi.org/10.1007/s12020-023-03324-8

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