Electromyographic findings after different selective neck dissections

Tetsuya Tsuji, Akira Tanuma, Tetsuro Onitsuka, Mitsuru Ebihara, Yoshiyuki Iida, Akio Kimura, Meigen Liu

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

OBJECTIVES: The objective was to compare electrophysiologic investigations of the upper trapezius muscle (UT) after different selective neck dissections (SND) and analyze the differences between types of SND and the preservation and excision of the cervical nerves (the C2-4 rami of the cervical plexus). STUDY DESIGN: Retrospective study of 54 patients (average age, 65.1 ± 9.6 yr, 45 males) with 70 SND. METHODS: Patients underwent needle electromyography (EMG) of the UT by 4 months after surgery. The findings were rated according to the 5 point EMG scale system from 1 (total denervation: positive sharp wave or fibrillation potential at rest and electrical silence at voluntary contraction) to 5 (normal pattern). RESULTS: The average EMG scale was 1.7 ± 1.1, 58.6% for score 1 and only 5.7% for score 5. There was not a significant difference in the EMG scale between the types of SND, whereas the group in which the cervical nerves were excised was significantly lower than in that in which it was preserved. The average EMG scales in the former and latter were 1.5 ± 0.8 and 2.0 ± 1.3, 68.8%. CONCLUSIONS: The study data confirm that complete or incomplete denervation of the UT was caused by axonal injury of the spinal accessory nerve, even though it was spared, because of traction of the nerve during neck dissection. Second, the excision of the C2 to 4 rami of the cervical plexus caused worse damage of the UT. It is suggested that it is important to preserve the cervical nerves to avoid denervation of the UT.

Original languageEnglish
Pages (from-to)319-322
Number of pages4
JournalLaryngoscope
Volume117
Issue number2
DOIs
Publication statusPublished - 2007 Feb

Fingerprint

Neck Dissection
Superficial Back Muscles
Electromyography
Denervation
Cervical Plexus
Accessory Nerve Injuries
Traction
Needles
Retrospective Studies

Keywords

  • Cervical nerve
  • Cervical plexus
  • Needle electromyography
  • Spinal accessory nerve
  • Trapezius muscle

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Electromyographic findings after different selective neck dissections. / Tsuji, Tetsuya; Tanuma, Akira; Onitsuka, Tetsuro; Ebihara, Mitsuru; Iida, Yoshiyuki; Kimura, Akio; Liu, Meigen.

In: Laryngoscope, Vol. 117, No. 2, 02.2007, p. 319-322.

Research output: Contribution to journalArticle

Tsuji, T, Tanuma, A, Onitsuka, T, Ebihara, M, Iida, Y, Kimura, A & Liu, M 2007, 'Electromyographic findings after different selective neck dissections', Laryngoscope, vol. 117, no. 2, pp. 319-322. https://doi.org/10.1097/01.mlg.0000249781.20989.5c
Tsuji, Tetsuya ; Tanuma, Akira ; Onitsuka, Tetsuro ; Ebihara, Mitsuru ; Iida, Yoshiyuki ; Kimura, Akio ; Liu, Meigen. / Electromyographic findings after different selective neck dissections. In: Laryngoscope. 2007 ; Vol. 117, No. 2. pp. 319-322.
@article{5d7b8021809644cbac1659a723ce1c9f,
title = "Electromyographic findings after different selective neck dissections",
abstract = "OBJECTIVES: The objective was to compare electrophysiologic investigations of the upper trapezius muscle (UT) after different selective neck dissections (SND) and analyze the differences between types of SND and the preservation and excision of the cervical nerves (the C2-4 rami of the cervical plexus). STUDY DESIGN: Retrospective study of 54 patients (average age, 65.1 ± 9.6 yr, 45 males) with 70 SND. METHODS: Patients underwent needle electromyography (EMG) of the UT by 4 months after surgery. The findings were rated according to the 5 point EMG scale system from 1 (total denervation: positive sharp wave or fibrillation potential at rest and electrical silence at voluntary contraction) to 5 (normal pattern). RESULTS: The average EMG scale was 1.7 ± 1.1, 58.6{\%} for score 1 and only 5.7{\%} for score 5. There was not a significant difference in the EMG scale between the types of SND, whereas the group in which the cervical nerves were excised was significantly lower than in that in which it was preserved. The average EMG scales in the former and latter were 1.5 ± 0.8 and 2.0 ± 1.3, 68.8{\%}. CONCLUSIONS: The study data confirm that complete or incomplete denervation of the UT was caused by axonal injury of the spinal accessory nerve, even though it was spared, because of traction of the nerve during neck dissection. Second, the excision of the C2 to 4 rami of the cervical plexus caused worse damage of the UT. It is suggested that it is important to preserve the cervical nerves to avoid denervation of the UT.",
keywords = "Cervical nerve, Cervical plexus, Needle electromyography, Spinal accessory nerve, Trapezius muscle",
author = "Tetsuya Tsuji and Akira Tanuma and Tetsuro Onitsuka and Mitsuru Ebihara and Yoshiyuki Iida and Akio Kimura and Meigen Liu",
year = "2007",
month = "2",
doi = "10.1097/01.mlg.0000249781.20989.5c",
language = "English",
volume = "117",
pages = "319--322",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Electromyographic findings after different selective neck dissections

AU - Tsuji, Tetsuya

AU - Tanuma, Akira

AU - Onitsuka, Tetsuro

AU - Ebihara, Mitsuru

AU - Iida, Yoshiyuki

AU - Kimura, Akio

AU - Liu, Meigen

PY - 2007/2

Y1 - 2007/2

N2 - OBJECTIVES: The objective was to compare electrophysiologic investigations of the upper trapezius muscle (UT) after different selective neck dissections (SND) and analyze the differences between types of SND and the preservation and excision of the cervical nerves (the C2-4 rami of the cervical plexus). STUDY DESIGN: Retrospective study of 54 patients (average age, 65.1 ± 9.6 yr, 45 males) with 70 SND. METHODS: Patients underwent needle electromyography (EMG) of the UT by 4 months after surgery. The findings were rated according to the 5 point EMG scale system from 1 (total denervation: positive sharp wave or fibrillation potential at rest and electrical silence at voluntary contraction) to 5 (normal pattern). RESULTS: The average EMG scale was 1.7 ± 1.1, 58.6% for score 1 and only 5.7% for score 5. There was not a significant difference in the EMG scale between the types of SND, whereas the group in which the cervical nerves were excised was significantly lower than in that in which it was preserved. The average EMG scales in the former and latter were 1.5 ± 0.8 and 2.0 ± 1.3, 68.8%. CONCLUSIONS: The study data confirm that complete or incomplete denervation of the UT was caused by axonal injury of the spinal accessory nerve, even though it was spared, because of traction of the nerve during neck dissection. Second, the excision of the C2 to 4 rami of the cervical plexus caused worse damage of the UT. It is suggested that it is important to preserve the cervical nerves to avoid denervation of the UT.

AB - OBJECTIVES: The objective was to compare electrophysiologic investigations of the upper trapezius muscle (UT) after different selective neck dissections (SND) and analyze the differences between types of SND and the preservation and excision of the cervical nerves (the C2-4 rami of the cervical plexus). STUDY DESIGN: Retrospective study of 54 patients (average age, 65.1 ± 9.6 yr, 45 males) with 70 SND. METHODS: Patients underwent needle electromyography (EMG) of the UT by 4 months after surgery. The findings were rated according to the 5 point EMG scale system from 1 (total denervation: positive sharp wave or fibrillation potential at rest and electrical silence at voluntary contraction) to 5 (normal pattern). RESULTS: The average EMG scale was 1.7 ± 1.1, 58.6% for score 1 and only 5.7% for score 5. There was not a significant difference in the EMG scale between the types of SND, whereas the group in which the cervical nerves were excised was significantly lower than in that in which it was preserved. The average EMG scales in the former and latter were 1.5 ± 0.8 and 2.0 ± 1.3, 68.8%. CONCLUSIONS: The study data confirm that complete or incomplete denervation of the UT was caused by axonal injury of the spinal accessory nerve, even though it was spared, because of traction of the nerve during neck dissection. Second, the excision of the C2 to 4 rami of the cervical plexus caused worse damage of the UT. It is suggested that it is important to preserve the cervical nerves to avoid denervation of the UT.

KW - Cervical nerve

KW - Cervical plexus

KW - Needle electromyography

KW - Spinal accessory nerve

KW - Trapezius muscle

UR - http://www.scopus.com/inward/record.url?scp=33846804331&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846804331&partnerID=8YFLogxK

U2 - 10.1097/01.mlg.0000249781.20989.5c

DO - 10.1097/01.mlg.0000249781.20989.5c

M3 - Article

C2 - 17204991

AN - SCOPUS:33846804331

VL - 117

SP - 319

EP - 322

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 2

ER -