Surgical Method to Accidents of the Cervical Plexus and Its Peripheral Nerve Branches.
Plast Reconstr Surg. 2018 04;141(four):1021-1025
Authors: Brown DL, Dellon AL
BACKGROUND: Positioned within the neck beneath the sternocleidomastoid muscle, the cervical plexus contains a coalition of nerves originating from C1 by C4, which offer enter to 4 cutaneous, seven motor, and three cranial nerves and the sympathetic trunk. Sporadic cases of harm to those superficial nerves have been reported. However, this particular anatomical reason behind neurogenic ache stays incompletely described and underrecognized.
METHODS: Twelve sufferers introduced with ache and have been recognized with numerous mixtures of harm to the lesser occipital, nice auricular, transverse cervical, and supraclavicular nerves. Inciting occasions included prior face carry, migraine, and thoracic outlet procedures; and traumatic occasions together with seatbelt trauma, a fall, and a clavicular fracture. Historical past and examination urged harm to the cervical plexus, and nerve blocks confirmed the diagnoses. Neurectomy with intramuscular transposition was carried out for 3 nerve branches in a single affected person, two branches in two sufferers, and one department within the remaining 9 sufferers.
RESULTS: 9 of the twelve sufferers had full reduction of their cervical plexus-related ache. The three failures have been in sufferers with ache after earlier face-lift surgical procedure. Residual notion of neck tightness and choking sensation persevered regardless of reduction of cheek and ear ache.
CONCLUSIONS: Data of the cervical plexus anatomy and its branches is essential for surgeons working on this space to attenuate iatrogenic nerve harm. As well as, neuromas needs to be thought-about a probable reason behind ache and dysesthesia following surgical procedure or harm. Correct analysis and surgical intervention can have a considerably optimistic impact on these debilitating issues.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
PMID: 29595737 [PubMed – indexed for MEDLINE]