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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Intraoperative electromyography for identification of the trapezius muscle innervation: clinical proof of a new anatomical concept.
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Intraoperative electromyography for identification of the trapezius muscle innervation: clinical proof of a new anatomical concept.

机译：术中肌电图识别斜方肌神经支配：一种新的解剖学概念的临床证明。

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OBJECTIVE/HYPOTHESIS There is still considerable controversy among surgeons on trapezius muscle innervation. In addition, the rate of unexpected postoperative trapezius pareses is unacceptably high. Recent anatomical findings might answer most of the questions. The objective of the present study was to clinically prove the recent anatomical findings, especially the concept of the innervation of the descending part of the trapezius muscle.STUDY DESIGN Intraoperative electromyography of the spinal accessory nerve and its branches in the posterior triangle of the neck.SETTING Intraoperative electromyography was performed during 17 modified radical neck dissections on 14 patients of both sexes ranging in age from 44 to 68 years (mean age, 56 y). Potentials were registered through pairs of needle electrodes placed in each of the three parts of the trapezius muscle. Intraoperatively, the spinal accessory nerve and its fine cranial branch passing toward the descending part of the muscle were identified and stimulated in the posterior triangle of the neck.RESULTS Stimulation of the fine cranial branch of the spinal accessory nerve led to a clearly visible and recordable contraction in the descending part of the trapezius muscle in all patients. Stimulation of the main trunk of the spinal accessory nerve in the posterior triangle of the neck distal to the above-mentioned branching led to a clearly visible and recordable contraction in the transverse and ascending parts of the muscle.CONCLUSIONS The results strongly support recent anatomical findings showing that, functionally, the most important descending part of the trapezius muscle is innervated by a fine single branch arising from the spinal accessory nerve in the posterior triangle of the neck. This may help to prevent more patients undergoing modified radical neck dissections from shoulder-arm syndrome.
机译：目的/假设外科医生在斜方肌神经支配方面仍有相当大的争议。此外，意外的斜方肌术后并发症发生率很高。最近的解剖学发现可能会回答大多数问题。本研究的目的是临床证明最近的解剖学发现，特别是斜方肌下降部分的神经支配的概念。研究设计脊髓副神经及其在颈后三角区的分支的术中肌电图。设置术中肌电图检查是在17例经改良的根治性颈清扫术中对14例年龄在44至68岁（平均年龄56岁）的男女患者进行的。通过放置在斜方肌三部分中每对中的成对针形电极记录电位。术中在脊髓的后三角区识别并刺激了脊髓副神经及其细小颅支，并对其进行了刺激。结果刺激脊髓副神经的细颅支可清晰可见并记录下来所有患者斜方肌下降部分的收缩。刺激上述分支远端的颈后三角区的脊柱副神经的主干可导致肌肉的横向和上升部分清晰可见且可记录的收缩。结论该结果有力地支持了最近的解剖学发现从功能上显示，斜方肌最重要的下降部分是由颈部后三角区的脊柱副神经产生的细小单支支配的。这可能有助于防止更多的患者因肩臂综合征而接受改良的根治性颈清扫术。

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