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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]
The sternocleidomastoid muscle originates from two locations: the manubrium of the sternum and the clavicle. [4] It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull by a thin aponeurosis. [4] [5] The sternocleidomastoid is thick and narrow at its center, and broader and thinner ...
The sternocleidomastoid muscle is tested by asking the patient to turn their head to the left or right against resistance. [ 8 ] One-sided weakness of the trapezius may indicate injury to the nerve on the same side of an injury to the spinal accessory nerve on the same side (Latin: ipsilateral ) of the body being assessed. [ 8 ]
It may also involve the cervical ganglia of the sympathetic trunk. Paralysis is caused by a lesion in the retroparotid space, which is bounded posteriorly by the cervical vertebrae, superiorly by the skull near the jugular foramen, anteriorly by the parotid gland, laterally by the sternocleidomastoid muscle, and medially by the pharynx.
Laterocollis is the tilting of the head from side to side. This is the "ear-to-shoulder" version. This involves many more muscles: ipsilateral sternocleidomastoid, ipsilateral splenius, ipsilateral scalene complex, ipsilateral levator scapulae, and ipsilateral posterior paravertebrals. The flexion of the neck (head tilts forwards) is anterocollis.
Torticollis, also known as wry neck, is a painful, dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term torticollis is derived from Latin tortus 'twisted' and collum 'neck'.
Anterior to sternocleidomastoid muscle, posterior to submandibular gland, lateral to carotid sheath. They are medial to the facial nerve at the anterior neck and above the hyoid bone. Skin pit can be found in this location. However, if skin pits are found on both sides of the neck, then, branchio-oto-renal syndrome should be ruled
Bezold's abscess is an abscess deep to the sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of the mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fossa, and deep to the investing layer of the deep cervical fascia.