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There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
Injury to the spinal accessory nerve commonly occurs during neck surgery, including neck dissection and lymph node excision. It can also occur as a result of blunt or penetrating trauma, and in some causes spontaneously. [17] [5] Damage at any point along the nerve's course will affect the function of the nerve. [10]
Hilton's law, espoused by John Hilton in a series of medical lectures given in 1860–1862, [1] is the observation that in the study of anatomy, the nerve supplying the muscles extending directly across and acting at a given joint not only supplies the muscle, but also innervates the joint and the skin overlying the muscle.
The fibers from the accessory nerve nucleus travel upward to enter the cranium via the foramen magnum. The internal carotid artery to reach both the sternocleidomastoid muscles and the trapezius. After a signal reaches the accessory nerve nucleus in the anterior horn of the spinal cord, the signal is conveyed to motor endplates on the muscle ...
The accessory nerve (CN XI) is particularly vulnerable to damage during lymph node biopsy. Damage results in an inability to shrug the shoulders or raise the arm above the head, particularly due to compromised trapezius muscle innervation.
Denervation can occur as a consequence of nerve injury. The three primary categories of nerve injury are neurapraxia, axonotmesis, and neurotmesis, each corresponding to varying degrees of damage and potential for recovery. In cases of nerve injury, the brain demonstrates an impressive ability to rewire or reorganize its neuronal circuitry ...
These paresthesias may be painful, such as shooting pain, burning, or a dull ache. They may also be pain-free, such as numbness or tingling. Motor nerve entrapment may present with muscle weakness or paralysis for voluntary movements of the innervated muscles. Entrapment of certain pelvic nerves can cause incontinence and/or sexual dysfunction. [2]
The accessory deep peroneal nerve is an anomalous nerve in which the nerve splits off from the common peroneal nerve and sometimes innervates the extensor digitorum brevis muscle. By itself, the condition is harmless but in conjunction with other neurological and structural defects in the area, can make the condition more difficult. [1]