Reinnervation of the Trapezius Muscle

The eleventh cranial nerve shoulder syndrome, which results from denervation of the trapezius muscle, contributes significantly to the postoperative morbidity of radical neck dissections. Multiple techniques exist for the reinnervation of muscles that have injured motor nerves. Reinnervation of denervated trapezius muscles was examined in the New Zealand white rabbit by use of three techniques of reinnervation: (1) neuromuscular pedicle transfer of the accessory nerve from the trapezius muscle, (2) direct accessory nerve implantation, and (3) neuromuscular pedicle transfer of the accessory nerve from the sternocleidomastoid muscle. The reinnervated trapezius muscles were examined grossly by direct nerve stimulation, electrophysiologically by evoked electromyography, and histologically by enzymatic muscle staining and silver-reducing nerve staining. The gross, electrophysiologic, and histologic results confirmed successful reinnervation of the trapezius muscle within 6 weeks of operation. No significant difference was observed between the various techniques of reinnervation.