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Intra-operative monitoring of the spinal accessory nerve: a systematic review

Published online by Cambridge University Press:  29 August 2014

A C McGarvey ,
G R Hoffman ,
P G Osmotherly  and
P E Chiarelli
A C McGarvey*
Affiliation:
Physiotherapy Department, Calvary Mater Newcastle Hospital, NSW, Australia School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
G R Hoffman
Affiliation:
School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, Australia Department of Surgery, John Hunter Hospital, New Lambton, NSW, Australia
P G Osmotherly
Affiliation:
School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
P E Chiarelli
Affiliation:
School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, Australia
*
Address for correspondence: Aoife C McGarvey, Physiotherapy department, Calvary Mater Newcastle Hospital, Edith St, Waratah, NSW 2298, Australia E-mail: [email protected]
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Abstract

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.

Keywords

Neck DissectionAccessory NerveIntraoperative Neurophysiological Monitoring
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 746 - 751
Copyright
Copyright © JLO (1984) Limited 2014 

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