What are the examination items of accessory nerve injury?

summary

The accessory nerve is pure motor nerve, which is divided into two parts: cerebral nerve and spinal nerve root. The medulla oblongata is small, and it originates from the inferior part of the nucleus ambiguus. The nerve fibers under the vagus nerve, as 4-5 roots, penetrate the lateral side of the medulla oblongata and merge with the spinal root when they move outward to the jugular foramen. After passing through the jugular foramen and leaving the skull, it is separated from the spinal cord and joined with the vagus nerve, which innervates the pharyngeal muscle and the recurrent laryngeal branch of the vagus nerve and supplies the proper muscles of the soft palate and larynx. What are the examination items of accessory nerve injury? Let's share my experience with you.

What are the examination items of accessory nerve injury?

1. Neuroimaging examination: when the accessory nerve injury is suspected to be caused by skull base tumor or brain stem lesion, CT and MRI are helpful for the diagnosis of primary disease. 2. EMG showed that the insertion potential of trapezius muscle and sternocleidomastoid muscle was significantly prolonged or there was no induced electric response, so the diagnosis of accessory nerve injury could be established.

Iatrogenic injury: the extracranial segment of accessory nerve was mostly injured by neck surgery, and the most common injury was caused by lymph node biopsy or excision in the posterior cervical triangle, with an incidence of 3% - 6%. Part of the injuries occurred in the neck tumor resection and carotid artery surgery.

Tumor infiltration or compression: for example, cervical lymph node tuberculosis and cervical malignant tumor can cause injury of accessory nerve extracranial segment; Tumors in foramen magnum and cerebellopontine angle can cause injury of jugular foramen and intracranial segment. Skull base fracture: when the skull base fracture is caused by craniocerebral trauma, the fracture line passes through the occipital condyle and involves the jugular foramen, which can cause contusion or compression of the jugular foramen and intracranial accessory nerves.

matters needing attention

The function of accessory nerve can be recovered to a certain extent if the cause can be removed and the severed nerve can be reconstructed. Especially, it is of great significance to reconstruct the accessory nerve of the spinal cord.