Nerve and vein preserving neck dissections for oral cancers: a prospective evaluation of spinal accessory nerve function and internal jugular vein patency following treatment

• Published in: Acta otorhino-laryngologica italica 2018-02, Vol.38 (1), p.7-12
• Main Authors: Reddy, G R Kumar, Hulikal, N, Lakshmi, A Y, Vengamma, B
• Format: Article
• Language: English
• Subjects: Accessory Nerve - physiology; Female; Humans; Jugular Veins - physiology; Male; Middle Aged; Mouth Neoplasms - surgery; Neck Dissection - methods; Organ Sparing Treatments; Prospective Studies; Quality of Life; Vascular Patency
• ISSN: 1827-675X; 1827-675X
• DOI: 10.14639/0392-100X-1481

Nerve and vein preserving modification of the radical neck dissection is commonly used in the management of oral squamous cell cancers. There is limited literature addressing nerve function and vein patency following treatment. We prospectively analysed 65 patients with nerve conduction study using surface electromyography at baseline, 1 month and 6 months post-surgery and colour Doppler of the internal jugular vein at baseline and 1 month post-surgery. We also studied functional outcomes of nerve sparing with arm abduction test and Neck Dissection Quality of Life questionnaire. There was a statistically significant increase in mean latency of motor action potential and decrease in the mean amplitude of the motor action potential following surgery, suggesting nerve dysfunction. Following surgery, there was a significant decrease in the diameter of the vein as well as an increase in the velocity of blood flow; there was partial thrombus in 5% of individuals. In conclusion, even though nerve dysfunction compromised shoulder abduction, vein dysfunction rarely resulted in any significant clinical impact.