변형 근치적 림프절 곽청술 시행 중 발생한 상완신경총 손상에 대한 신경봉합술 치료 1례

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.