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October 1961

A Syndrome Resulting from Radical Neck Dissection

Arch Otolaryngol. 1961;74(4):424-428. doi:10.1001/archotol.1961.00740030433011

Many surgeons consider sacrifice of the spinal accessory nerve necessary in radical neck dissection. Excision of this nerve results in anatomical and functional disabilities of the shoulder functions on the side operated on. Since this operation is being performed with increasing frequency, it is well to review the disability resulting from section of this nerve.

Anatomy  Inman and associates studied the functions of the shoulder joint intensively and reported on them in detail.4 They noted that when the arm is in the resting position, the role of the trapezius muscle is entirely supportive. With the first 35 degrees of arm elevation, this muscle functions equally in supportive and rotatory roles. From 35 to 140 degrees, the muscle is increasingly effective as a rotator, with maximum power at 90 degrees. Beyond 140 degrees, the rotatory efficiency decreases, and again the supportive function predominates. The rhomboids are most active during abduction

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