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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 -
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 -
Neurological Research May 2023Dual nerve transfer of the spinal accessory nerve to the suprascapular nerve (SAN-SSN) and the radial nerve to the axillary nerve is considered to be the most feasible... (Meta-Analysis)
Meta-Analysis
Dual nerve transfer of the spinal accessory nerve to the suprascapular nerve (SAN-SSN) and the radial nerve to the axillary nerve is considered to be the most feasible method of restoration of shoulder abduction in brachial plexus injuries. Supraspinatus muscle plays an important role in the initiation of abduction and its functional restoration is crucial for shoulder movements. There are two possible approaches for the SAN-SSN transfer: the more conventional anterior approach and the posterior approach in the area of scapular spine, which allows more distal neurotization. Although the dual nerve transfer is a widely used method, it is unclear which approach for the SAN-SSN transfer results in better outcomes. We conducted a search of English literature from January 2001 to December 2021 using the PRISMA guidelines. Twelve studies with a total 142 patients met our inclusion criteria. Patients were divided into two groups depending on the approach used: Group A included patients who underwent the anterior approach, and Group B included patients who underwent the posterior approach. Abduction strength using the Medical Research Scale (MRC) and range of motion (ROM) were assessed. The average MRC grade was 3.57 ± 1.08 in Group A and 4.0 ± 0.65 (p = 0.65) in Group B. The average ROM was 114.6 ± 36.7 degrees in Group A and 103.4 ± 37.2 degrees in Group B (p = 0.247). In conclusion, we did not find statistically significant differences between SAN-SSN transfers performed from the anterior or posterior approach in patients undergoing dual neurotization technique for restoration of shoulder abduction.
Topics: Humans; Nerve Transfer; Accessory Nerve; Radial Nerve; Axilla; Scapula; Shoulder; Brachial Plexus
PubMed: 36526442
DOI: 10.1080/01616412.2022.2156721 -
International Journal of Oral and... Jan 2023The relationship between the spinal accessory nerve and internal jugular vein is important for modified neck dissection surgery. Therefore, the aim of this review was to... (Meta-Analysis)
Meta-Analysis
The relationship between the spinal accessory nerve and internal jugular vein is important for modified neck dissection surgery. Therefore, the aim of this review was to investigate variations in this relationship. Through a search of the PubMed, Scopus, Web of Science, LILACS, and SciELO databases, the review authors collected anatomical data for inclusion in a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four relationship patterns were identified and classified: type 1, the nerve lies superficial to the vein; type 2, the nerve lies deep to the vein; type 3, the nerve crosses the branches of the vein; type 4, the nerve splits and its branches pass around the vein. The last pattern was not included in the meta-analysis. Eighteen studies were included (useful sample of 1491 hemi-necks). Type 1 variation had a prevalence of 79.7% (95% CI 77.6-81.7%), type 2 had a prevalence of 19.6% (95% CI 17.7-21.7%), and the type 3 had a prevalence of 0.7% (95% CI 0.0-1.4%). Significant differences were found among geographical subgroups. Normally, the spinal accessory nerve passes superficial to the internal jugular vein, but anatomical variations are common and there is a geographical influence. These findings are important for the safety of modified radical neck dissections.
Topics: Humans; Accessory Nerve; Jugular Veins; Neck Dissection; Neck; Prevalence
PubMed: 35367117
DOI: 10.1016/j.ijom.2022.03.008 -
The Journal of Laryngology and Otology Dec 2007The XIth cranial nerve or accessory nerve provides the motor supply to the sternocleidomastoid and trapezius muscles. It is frequently encountered during neck surgery,... (Review)
Review
The XIth cranial nerve or accessory nerve provides the motor supply to the sternocleidomastoid and trapezius muscles. It is frequently encountered during neck surgery, and as such is at risk of iatrogenic injury, resulting in the 'shoulder syndrome'. Historically, the nerve was sacrificed on oncological grounds during radical neck dissection. However, the basis for sacrifice is unfounded in the majority of cases, and accessory nerve sparing selective neck dissection has equal oncological efficacy. The path of the nerve in the neck is very variable, and there is not a wholly reliable landmark for its identification. However, there are a number of methods described in the literature to guide the surgeon in its identification. This paper provides a systematic review of all the methods available for identification of the accessory nerve, and comments on the reliability of each. In doing so, the detailed anatomy of the accessory nerve is also described.
Topics: Accessory Nerve; Accessory Nerve Injuries; Humans; Neck; Neck Dissection; Neck Muscles; Postoperative Complications
PubMed: 17892604
DOI: 10.1017/S0022215107000461 -
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 -
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 -
Journal of Anesthesia History Jul 2016Accessory innervation (AI) may account for the persistent sensation perceived after successful mandibular anesthesia in the adult patient. The purpose of this systematic... (Review)
Review
INTRODUCTION
Accessory innervation (AI) may account for the persistent sensation perceived after successful mandibular anesthesia in the adult patient. The purpose of this systematic review was to record the quality of evidence pertaining to the cervical plexus (CP) AI in dental anesthesia.
MATERIALS AND METHODS
Electronic and manual searches were conducted using Ovid and Medline of articles published from 1922 to March of 2015. Studies written in any language were included as long as they involved: (i) humans, animals, and/or cadavers AND (ii) anatomical and/or research anesthetic-technique approaches and/or clinical approaches. Exclusion criteria were (i) maxillary buccal infiltration, (ii) no abstract/paper available, (iii) studies that do not comprise the description of the branches of the CP branches in dentistry and (iv) duplicated articles. The articles were reviewed and graded by levels of evidence (LOE) through a methodological scoring index (MSI).
RESULTS
Forty-four out of 185 papers fulfilled the inclusion criteria. One randomized control trial, 3 comprehensive reviews, 1 cohort study, 5 case series/reports, 16 poor-quality cohort and case series/reports and 18 reviews/case, reports/expert opinions were found. Of the 44 publications, there were 4 LOE 1, 1 LOE 2, 5 LOE 3, 20 LOE 4 and 14 LOE 5 studies.
CONCLUSIONS
The MSI helped to classify papers LOE in a standardized and objective approach. The objective evidence quality occurrence recorded was found to be LOE 4 (n = 20) > LOE 5 (n = 14) > LOE 3 (n = 5) > LOE 1 (n = 4) > LOE 2 (n = 1). The anatomy of the CP needs to be reexamined and understood in the anatomical literature.
Topics: Anesthesia, Dental; Anesthesia, Local; Cervical Plexus; Cervical Plexus Block; Evidence-Based Dentistry; Humans; Mandible; Mandibular Nerve; Spinal Nerves; Tooth
PubMed: 27480473
DOI: 10.1016/j.janh.2016.04.010 -
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 -
Journal of Reconstructive Microsurgery Oct 2020The aim of this study was to compare postoperative elbow flexion outcomes in patients receiving functioning free muscle transplantation (FFMT) innervated by either... (Meta-Analysis)
Meta-Analysis
Functioning Free Muscle Transfer for Brachial Plexus Injury: A Systematic Review and Pooled Analysis Comparing Functional Outcomes of Intercostal Nerve and Spinal Accessory Nerve Grafts.
BACKGROUND
The aim of this study was to compare postoperative elbow flexion outcomes in patients receiving functioning free muscle transplantation (FFMT) innervated by either intercostal nerve (ICN) or spinal accessory nerve (SAN) grafts.
METHODS
A comprehensive systematic review on FFMT for brachial plexus reconstruction was conducted utilizing Medline/PubMed database. Analysis was designed to compare functional outcomes between (1) nerve graft type (ICN vs. SAN) and (2) different free muscle graft types to biceps tendon (gracilis vs. rectus femoris vs. latissimus dorsi).
RESULTS
A total of 312 FFMTs innervated by ICNs (169) or the SAN (143) are featured in 10 case series. The mean patient age was 28 years. Patients had a mean injury to surgery time of 31.5 months and an average follow-up time of 39.1 months with 18 patients lost to follow-up. Muscles utilized included the gracilis (275), rectus femoris (28), and latissimus dorsi (8). After excluding those lost to follow-up or failures due to vascular compromise, the mean success rates of FFMTs innervated by ICNs and SAN were 64.1 and 65.4%, respectively.
CONCLUSION
This analysis did not identify any difference in outcomes between FFMTs via ICN grafts and those innervated by SAN grafts in restoring elbow flexion in traumatic brachial plexus injury patients.
Topics: Accessory Nerve; Adult; Brachial Plexus; Brachial Plexus Neuropathies; Humans; Intercostal Nerves; Nerve Transfer; Quadriceps Muscle; Recovery of Function
PubMed: 32526776
DOI: 10.1055/s-0040-1713147