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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]
In the past, dopamine blocking agents have been used in the treatment of spasmodic torticollis. Treatment was based on the theory that there is an imbalance of the neurotransmitter dopamine in the basal ganglia. These drugs have fallen out of fashion due to various serious side effects: sedation, parkinsonism, and tardive dyskinesia. [16]
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 ]
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 gets its blood from different arteries in the neck, which bring oxygen and nutrients to keep the muscle healthy. Torticollis can happen when there are issues with the sternocleidomastoid muscle, like if it's too short, causing the head and neck to be in an odd position. [ 25 ]
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
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.
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.