Int J Thyroidol.  2020 May;13(1):43-46. 10.11106/ijt.2020.13.1.43.

A Case of Brachial Plexus Neurorrhaphy During Revisional Modified Radical Neck Dissection

• Lee MK
• Kang HT
• Kim SY
• Lee SW

• KMID: 2502259
• DOI: http://doi.org/10.11106/ijt.2020.13.1.43

Abstract

The brachial plexus originates from the ventral rami of spinal nerves C5–T1 and lies between the anterior and middle scalene muscles. Brachial plexus injury can occur as a rare complication of neck dissection or in association with trauma, malignancy, or radiotherapy. We performed modified radical neck dissection in a female with cervical lymph node metastasis of a recurrent papillary thyroid carcinoma. Brachial plexus injury occurred because of severe adhesion and anatomical distortion during the surgical revision and was immediately treated via end-to-end neurorrhaphy. After surgery, the patient felt pain and numbness in her right shoulder and arm. Motor function was grade 0 on right shoulder flexion, arm abduction and elbow flexion. After 1 year of follow-up, both motor and sensory function had fully recovered. This is the first reported case of complete motor function restoration after brachial plexus neurorrhaphy in a patient treated in the Republic of Korea.

Keyword

Brachial plexus injury; Modified radical neck dissection; Neurorrhaphy

Figure

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  Fig. 1 Intraoperative view. (A) Injury of brachial plexus and (B) end-to-end neurgorrhaphy between brachial plexus.

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  Fig. 2 POD 6 months. (A) Arm abduction, (B) shoulder flexion and (C) elbow flexion.

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  Fig. 3 POD 1 year. (A) Arm abduction, (B) shoulder flexion and (C) elbow flexion.

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