• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.152-156
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• 2014

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.48-53
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• 2020

Background: The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. Conclusions: The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.

• Journal of Medicine and Life Science
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• v.15 no.1
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• pp.16-18
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• 2018

Anterior interosseous nerve palsy is known to occur uncommonly because of its compression by the accessory head of flexor pollicis longus(AHFPL) in the forearm. During routine educational dissection, we found 7 AHFPLs in 12 upper limbs of 6 adults Korean Jeju islander cadavers, which inserted onto flexor pollicis longus. Three AHFPLs of them arose from coronoid process of the ulna, and the others arose independently from the flexor digitorum superficialis (FDS). Using the topographical relationship of the anterior interosseous nerve to the AHFPL, all anterior interosseous nerve was crossed the tendinous part of the AHFPL. This study has shown that there are discrepancies in the origin of AHFPL and the location of the anterior interosseous nerve in Koreans, which is supposed to be related to unique genetic pool in Jeju Island.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.161-166
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• 2004

Objective: The aim of this study is to evaluate shoulder function and preoperative and postoperative electrophysiological changes related to the spinal accessory nerve with reference to neck dissection technique. Materials and Methods: We evaluated shoulder function by pain, strength and range of motion in a total of 35 neck dissection cases of 29 patients with head and neck cancer or thyroid papillary cancer. Electrophysiologic studies were performed before surgery, after third postoperative weeks and 6 months respectively. The results of each test according to the types of neck dissection were compared. Results: Clinical parameters of shoulder function and electrophysiologic study showed deterioration in early postoperative periods and improvements in late postoperative periods when the spinal accessory nerve was spared and permanent nerve damage was observed in radical neck dissection. There were correlations between the clinical parameters and electrophysiologic studies. Conclusion: The shoulder function after spinal accessory nerve sparing procedure is better than the function after nerve sacrificing procedure.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.61-65
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• 2015

The mental foramen is a bilateral opening in the vestibular portion of the mandible through which nerve endings, such as the mental nerve, emerge. In general, the mental foramen is located between the lower premolars. This region is a common area for the placement of dental implants. It is very important to identify anatomical variations in presurgical imaging exams since damage to neurovascular bundles may have a direct influence on treatment success. In the hemimandible, the mental foramen normally appears as a single structure, but there are some rare reports on the presence and number of anatomical variations; these variations may include accessory foramina. The present report describes the presence of accessory mental foramina in the right mandible, as detected by cone-beam computed tomography before dental implant placement.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.695-699
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• 2006

Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.

• Korean Journal of Veterinary Research
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• v.38 no.3
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• pp.474-487
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• 1998

The present study was undertaken to investigate the morphological characteristics of trigeminal nerve in the Korean native goat by macroscopic methods. Trigeminal nerve was originated from the lateral side of pons, and extended shortly forward to form trigeminal ganglion at the opening of oval foramen. Thereafter this nerve was divided into maxillary, mandibular and ophthalmic nerve. Ophthalmic nerve gave off the zygomaticotemporal branch, frontal nerve, frontal sinus branch, and was continued as the nasociliary nerve. Maxillary nerve gave rise to the zygomaticofacial branch, accessory zygomaticofacial branch, communicating branch with oculomotor nerve, pterygopalatine nerve, caudal superior alveolar branch, malar branch and was continued as the infraorbital nerve. Mandibular nerve was divided into the masseteric nerve, buccal nerve, lateral pterygoid nerve, medial pterygoid nerve, nerve to tensor tympani m., auriculotemporal nerve, and furnished the inferior alveolar nerve and lingual nerve as terminal branches. The course and distribution of the trigeminal nerve in the Korean native goat appeared to be similar to that in other small ruminants such as sheep and goat. But the main differences from other small ruminants were as follows : 1. There was no accessory branch of the major palatine nerve. 2. The caudal superior alveolar branch was directly branched from the maxillary nerve. 3. The communicating branch with oculomotor nerve was originated from maxillary nerve or common trunk with zygomaticofacial branch. 4. The malar branch arose from the maxillary nerve at the rostral to the origin of the caudal superior alveolar branch. 5. The inferior alveolar nerve originated in a common trunk with the lingual nerve. 6. The mylohyoid nerve arose at the origin of the inferior alveolar nerve. 7. The zygomaticotemporal branch was single fascicle, and gave off lacrimal nerve and cornual branch. 8. The base of horn was provided by the cornual branches of zygomaticotemporal branch and infratrochlear nerve of nasociliary nerve.

• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.142-147
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• 2019

Piriformis syndrome caused by an accessory belly of the piriformis muscle is very rare. Only a few cases have been reported. Here, we report a case of piriformis syndrome resulting from an extremely rare type of accessory belly of the piriformis muscle originated at the proximal third portion of the main piriformis muscle and attached separately to the greater trochanter inferior to the insertion of the main piriformis muscle. A definitive diagnosis of piriformis syndrome was made based on magnetic resonance imaging and magnetic resonance neurography findings that were consistent with results of nerve conduction study and needle electromyography.

• Journal of Convergence for Information Technology
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• v.11 no.12
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• pp.194-200
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• 2021

Recently, incorrect and unhealthy postures have become increasingly prevalent due to reasons such as smartphone use. Consequently, imbalanced muscle contraction occurs. In particular, if the oblique muscle is contracted, the accessory nerve will be compressed, causing ischemic pain in the upper trapezius muscle. To investigate the effect on pain in the upper trapezius muscle, this study applied the ischemic compression method to the accessory nerve capture point at the 1/3-point of the oblique cervical muscle. In this study, the ischemic compression method was applied to eight women twice a week for four weeks, and pain was evaluated before, immediately after, and three weeks after application. The visual analogue scale, McGill Pain Questionnaire, and pressure dynamometer were used to evaluate subjects' pain. As a result of this study, it was confirmed that the pain was significantly reduced after treatment, and that the pain reduction was still effective three weeks after completion of the intervention, indicating that the intervention on the accessory nerve compression point on the oblique cervical muscle was both effective and long-lasting for pain reduction in the upper trapezius muscle. Future studies should increase the number of subjects to check not only pain reduction in the upper trapezius muscle, but also improvement of neck function.