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CA: a Cancer Journal For Clinicians May 2016Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other... (Review)
Review
Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.
Topics: Accessory Nerve Diseases; Aftercare; American Cancer Society; Anxiety; Bursitis; Deglutition Disorders; Dental Care; Dental Caries; Depression; Disease Management; Dystonia; Fatigue; Gastroesophageal Reflux; Head and Neck Neoplasms; Health Promotion; Humans; Hypothyroidism; Lymphedema; Neck Muscles; Osteonecrosis; Periodontitis; Peripheral Nervous System Diseases; Respiratory Aspiration; Sleep Apnea Syndromes; Sleep Wake Disorders; Stress, Psychological; Survivors; Taste Disorders; Trismus; Vestibular Neuronitis; Voice Disorders; Xerostomia
PubMed: 27002678
DOI: 10.3322/caac.21343 -
Cureus Jan 2021The anatomy of the nasal cavities and paranasal sinuses is one of the most varied in the human body. The aim of this study is to review the prevalence of anatomical... (Review)
Review
The anatomy of the nasal cavities and paranasal sinuses is one of the most varied in the human body. The aim of this study is to review the prevalence of anatomical variations in the sinonasal area. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search from October 2004 until May 2020. The search strategy included the following keywords: ('paranasal sinus' OR 'frontal sinus' OR 'maxillary sinus' AND ('anatomical variants' OR 'anomalies')). Fifty studies were eligible and included in the analysis. Overall, the studies encompassed a total of 18,118 patients included in this review. Most common anatomical variations include agger nasi cells, nasal septum deviation and concha bullosa. Other variations seen in this region are uncinate process variations, paradoxical middle turbinate, Haller, Onodi and supraorbital ethmoid cells, accessory ostia of maxillary sinus. Less common variations include any sinus aplasia, crista galli pneumatization and dehiscence of the optic or maxillary nerve, internal carotid artery and lamina papyracea. Anatomical variations of this region also differ among ethnic groups. This study highlights the amount, variability and significance of most anatomical variants reported in the literature in the last years. It is essential for the sinus surgeon to have a broad spectrum of knowledge not only of "the typical" anatomy but also all the possible anatomical variations. With modern imaging modalities, anatomical variations can be detected, and uneventful pitfalls might be prevented.
PubMed: 33614330
DOI: 10.7759/cureus.12727 -
ANZ Journal of Surgery Mar 2023Neck dissection is a commonly performed procedure for oncologic control of head and neck malignancy. With contemporary modified radical and selective neck dissections,... (Review)
Review
BACKGROUND
Neck dissection is a commonly performed procedure for oncologic control of head and neck malignancy. With contemporary modified radical and selective neck dissections, haematoma, wound infection, tissue necrosis, chyle leak and injury involving the marginal mandibular, hypoglossal, vagus or accessory nerves are commonly described complications. Although the phrenic nerve courses within the surgical planes explored during a neck dissection and has a vital function in innervating the diaphragm, few studies have been performed to investigate the exact incidence of post-operative phrenic nerve paresis. This study aims to review the literature as to the rate of phrenic nerve injury following neck dissection.
METHODS
A systematic literature review was conducted from 2000 to 2022 including studies reporting on phrenic nerve paresis following neck dissection.
RESULTS
In total, 11 studies were included. The reported rate of immediate post-operative phrenic nerve paresis ranged from 0% to 5.3%, with an average rate of 0.613% (12/1959). The reported rate of phrenic nerve paresis at follow-up (1 month-127 months) ranged from 0% to 4.7%, with an average rate of 1.035% (5/483). There were no cases of bilateral phrenic nerve paresis reported in this period.
CONCLUSIONS
Phrenic nerve paresis is an uncommon complication following neck dissection, often asymptomatic and potentially underreported. Bilateral phrenic nerve paresis is exceedingly rare. Injury can be avoided by staying superficial to the prevertebral fascia when dissecting around the anterior scalene muscle. Routine phrenic nerve integrity monitoring is not commonly utilized but may aid intra-operative phrenic nerve identification or confirmation of function.
Topics: Humans; Phrenic Nerve; Neck Dissection; Head and Neck Neoplasms; Paresis
PubMed: 36792555
DOI: 10.1111/ans.18322 -
The Journal of Laryngology and Otology Sep 2014To investigate evidence that intra-operative nerve monitoring of the spinal accessory nerve affects the prevalence of post-operative shoulder morbidity and predicts... (Review)
Review
OBJECTIVE
To investigate evidence that intra-operative nerve monitoring of the spinal accessory nerve affects the prevalence of post-operative shoulder morbidity and predicts functional outcome.
METHODS
A search of the Medline, Scopus and Cochrane databases from 1995 to October 2012 was undertaken, using the search terms 'monitoring, intra-operative' and 'accessory nerve'. Articles were included if they pertained to intra-operative accessory nerve monitoring undertaken during neck dissection surgery and included a functional shoulder outcome measure. Further relevant articles were obtained by screening the reference lists of retrieved articles.
RESULTS
Only three articles met the inclusion criteria of the review. Two of these included studies suggesting that intra-operative nerve monitoring shows greater specificity than sensitivity in predicting post-operative shoulder dysfunction. Only one study, with a small sample size, assessed intra-operative nerve monitoring in neck dissection patients.
CONCLUSION
It is unclear whether intra-operative nerve monitoring is a useful tool for reducing the prevalence of accessory nerve injury and predicting post-operative functional shoulder outcome in patients undergoing neck dissection. Larger, randomised studies are required to determine whether such monitoring is a valuable surgical adjunct.
Topics: Accessory Nerve; Accessory Nerve Injuries; Head and Neck Neoplasms; Humans; Intraoperative Neurophysiological Monitoring; Muscle Weakness; Neck Dissection; Pain; Postoperative Complications; Shoulder
PubMed: 25170992
DOI: 10.1017/S0022215113002934 -
Shoulder & Elbow Jun 2020Trapezius palsy results from injury to the spinal accessory nerve. The condition presents with loss of shoulder abduction, pain, and winging of the scapula. Surgical... (Review)
Review
BACKGROUND
Trapezius palsy results from injury to the spinal accessory nerve. The condition presents with loss of shoulder abduction, pain, and winging of the scapula. Surgical treatment may improve functional outcomes and quality of life.
PURPOSE
The purpose of this study was to report and evaluate the clinical outcomes following surgical management of trapezius palsy.
STUDY DESIGN
Systematic review.
METHODS
The electronic databases EMBASE, MEDLINE, and PubMed were searched for studies and relevant data were abstracted. Only studies reporting on outcomes after the surgical treatments of trapezius palsy were included.
RESULTS
A total of 10 studies including 192 patients were included in this review. All surgical interventions resulted in improved function and pain reduction. Patients reported high satisfaction (90-92%) following nerve reconstruction or the Eden-Lange procedure, in comparison to neurolysis. The most common procedure reported was the Eden-Lange muscle transfer (32% reported cases) demonstrating the highest patient satisfaction rates with low complication rate of 7.7%.
CONCLUSION
Patients failing conservative treatment report good outcomes following surgical treatment of trapezius palsy. All reported surgical procedures demonstrate reduction in pain the best results from the Eden-Lange muscle transfer. Further high-quality comparative studies are required to make definitive conclusions regarding the comparative efficacy of each surgical procedure.
PubMed: 32565916
DOI: 10.1177/1758573219872730 -
Muscle & Nerve Sep 2022Ultrasonography of the cranial nerves has recently gained attention for assessment of inflammatory, compressive, or degenerative neuropathies. However, sonographic... (Meta-Analysis)
Meta-Analysis
INTRODUCTION/AIMS
Ultrasonography of the cranial nerves has recently gained attention for assessment of inflammatory, compressive, or degenerative neuropathies. However, sonographic reference values of cranial nerves have received less attention than those of peripheral nerves. In this systematic review and meta-analysis we aimed to provide current evidence of sonographic reference values for cranial nerve size.
METHODS
By searching Medline (via PubMed), Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, we conducted a systematic review and meta-analysis of studies that reported ultrasound measurements of the facial, spinal accessory, and hypoglossal nerves in healthy adults. We included studies that reported either the sonographic cross-sectional area (CSA) or the nerve diameter; the included nerves were subgrouped according to the site of nerve measurement.
RESULTS
Fourteen studies with a total of 661 participants and 1437 ultrasound nerve measurements met the inclusion criteria. The anatomical sites for each nerve were combined to provide single-nerve mean measurements. We found an overall mean nerve diameter of 0.80 mm for the facial nerve, 0.63 mm for the spinal accessory nerve, and 1.82 mm for hypoglossal nerve CSA.
DISCUSSION
This meta-analysis provides reference values for the diameter and cross-sectional area of the facial, spinal accessory, and hypoglossal nerves at different sites, which can be used as guidance in clinical practice to detect pathological changes in cranial nerve size in cranial neuropathies. We recommend further validation in large-scale studies as well as standardization of the scanning protocols.
Topics: Accessory Nerve; Adult; Humans; Hypoglossal Nerve; Peripheral Nerves; Reference Values; Ultrasonography
PubMed: 35765722
DOI: 10.1002/mus.27670 -
Surgical and Radiologic Anatomy : SRA May 2022Many etiologies are known to lead to a tarsal tunnel syndrome (TTS). One rare cause is mass-occupying lesions, and particularly accessory or variant muscles (AVM). This... (Review)
Review
PURPOSE
Many etiologies are known to lead to a tarsal tunnel syndrome (TTS). One rare cause is mass-occupying lesions, and particularly accessory or variant muscles (AVM). This study aimed to systematically collect published clinical cases of TTS caused by AVM.
METHODS
An electronic literature search was conducted from inception to April 2021. The diagnosis of AVM should be reported in one of the following methods: ultrasonography, magnetic resonance imaging (MRI), or per-operatively. Data extraction included types and prevalence of accessory muscles, clinical presentation and diagnosis, and treatment modalities. Twenty-five studies were identified with a total 39 patients (47 ankles).
RESULTS
The prevalence of TTS was reported in only two studies (9%). Forty-nine AVM were identified with the accessory flexor digitorum longus being the most common (52%). The most common sign/symptoms were tenderness (78.7%), pain (82.9%), dysesthesia (57.4%), Tinel sign (44.6%), and a swelling (25.5%). Decompression and excision were the most commonly performed procedures. Four accessory/variant muscles in the ankle have the potential to induce a tarsal tunnel syndrome.
CONCLUSION
This review highlights the clinical and imagery specificities of TTS secondary to accessory or variant muscles. Mass-occupying etiology should be included in the list of differential diagnoses whenever a posterior tibial nerve compression is suspected.
Topics: Ankle; Foot; Humans; Muscle, Skeletal; Musculoskeletal Abnormalities; Tarsal Tunnel Syndrome; Tibial Nerve
PubMed: 35353216
DOI: 10.1007/s00276-022-02932-9 -
Clinical Anatomy (New York, N.Y.) Jan 2024This study aimed to investigate the anatomy of the spinal accessory nerve (SAN) in the posterior cervical triangle, especially in relation to adjacent anatomical... (Meta-Analysis)
Meta-Analysis Review
This study aimed to investigate the anatomy of the spinal accessory nerve (SAN) in the posterior cervical triangle, especially in relation to adjacent anatomical landmarks, along with a systematic review of the current literature with a meta-analysis of the data. Overall, 22 cadaveric and three prospective intraoperative studies, with a total of 1346 heminecks, were included in the analysis. The major landmarks relevant to the entry of the SAN at the posterior border of the SCM muscle (PBSCM) were found to be the mastoid apex, the great auricular point (GAP), the nerve point (NP), and the point where the PBSCM meets the upper border of the clavicle. The SAN was reported to enter the posterior cervical triangle above GAP in 100% of cases and above NP in most cases (97.5%). The mean length of the SAN along its course from the entry point to its exit point from the posterior triangle of the neck was 4.07 ± 1.13 cm. The SAN mainly gave off 1 or 2 branches (32.5% and 31%, respectively) and received either no branches or one branch in most cases (58% and 23%, respectively) from the cervical plexus during its course in the posterior cervical triangle. The major landmarks relevant to the entry of the SAN at the anterior border of the TPZ muscle (ABTPZ) were found to be the point where the ABTPZ meets the upper border of the clavicle and the midpoint of the clavicle, along with the mastoid apex, the acromion, and the transverse distance of the SAN exit point to the PBSCM. The results of the present meta-analysis will be helpful to surgeons operating in the posterior cervical triangle, aiding the avoidance of the iatrogenic injury of the SAN.
Topics: Humans; Accessory Nerve; Prospective Studies; Cadaver; Neck; Neck Muscles
PubMed: 37767816
DOI: 10.1002/ca.24119 -
Hand (New York, N.Y.) May 2023Restoration of shoulder function in obstetrical brachial plexus injury is paramount. There remains debate as to the optimal method of upper trunk reconstruction. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Restoration of shoulder function in obstetrical brachial plexus injury is paramount. There remains debate as to the optimal method of upper trunk reconstruction. The purpose of this study was to test the hypothesis that spinal accessory nerve to suprascapular nerve transfer leads to improved shoulder external rotation relative to sural nerve grafting.
METHODS
A systematic review of Medline, EMBASE, EBSCO CINAHL, SCOPUS, Cochrane Library, and TRIP Pro from inception was conducted. Our primary outcome was shoulder external rotation.
RESULTS
Four studies were included. Nerve transfer was associated with greater shoulder external rotation relative to nerve grafting (mean difference: 0.82 AMS 95% confidence interval [CI]: 0.27-1.36, < .005). Patients undergoing nerve grafting were more likely to undergo a secondary shoulder stabilizing procedure (odds ratio [OR]: 1.27, 95% CI: 0.8376-1.9268).
CONCLUSION
In obstetrical brachial plexus injury, nerve transfer is associated with improved shoulder external rotation and a lower rate of secondary shoulder surgery.
LEVEL OF EVIDENCE
Level III; Therapeutic.
Topics: Humans; Shoulder; Nerve Transfer; Brachial Plexus Neuropathies; Retrospective Studies; Brachial Plexus; Birth Injuries
PubMed: 34448408
DOI: 10.1177/15589447211030691 -
European Journal of Surgical Oncology :... Jul 2017Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the... (Review)
Review
INTRODUCTION
Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications.
METHODS
Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies.
RESULTS
Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life.
CONCLUSIONS
The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications.
Topics: Head and Neck Neoplasms; Humans; Incidence; Neck; Neck Dissection; Postoperative Complications; Prevalence; Quality of Life; Range of Motion, Articular; Shoulder Joint; Shoulder Pain; Somatosensory Disorders
PubMed: 27956321
DOI: 10.1016/j.ejso.2016.10.026