Evaluation of the Clinical and Electrophysiological Impact of Cervical Lymph Node Curage on the Function of Accessory Spinal Nerve Xi

The most frequent complication of neck dissection is the spinal accessory nerve injury, particularly during level IIb dissection. The objective of our work is to assess the impact of this surgery on the function of the spinal accessory nerve, as well as to determine the risk factors associated with nerve lesions and to propose suitable rehabilitation strategies. We conducted a prospective study in the Physical Medicine and Rehabilitation Department at the Ibn Rochd University Hospital in Casablanca, in collaboration with the Otorhinolaryngology Department. The study included 29 patients (50 neck dissections) who underwent cervical lymph node dissection between January 2023 and December 2023 and were followed up in our department for 6 months after the operation. We included in this study all patients who had undergone cervical lymph node dissection, regardless of the initial indication. The analysis focused on clinical evaluation and electromyography (EMG) to identify alterations in the spinal accessory nerve and to identify factors influencing the evolution. These results indicate that neck dissection, particularly level IIb, may lead to significant neurological repercussions. These complications may disrupt patients’ quality of life, raising the question of the necessity of such an intervention in certain clinical indications. Although spontaneous clinical improvement is often observed, rehabilitation can play a crucial role in managing patients, helping to mitigate the effects of these residual effects. A reevaluation of surgical practices may also be necessary to balance oncologic efficacy and patients’ well-being