{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:07:52Z","timestamp":1790287672879,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T00:00:00Z","timestamp":1521504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>Intraoperative identification of the spinal accessory nerve (SAN) is key in reducing nerve injury. This study aims to explore the surgical anatomy of the SAN and 2 landmarks for its identification\u2014the sternocleidomastoid branch of the occipital artery (SBOA) and superior sternocleidomastoid tendon (SST)\u2014to propose a novel method of identifying the SAN during surgical neck dissections. Twelve cadavers underwent bilateral level II\u2010V neck dissection identifying the SAN, SBOA, and SST. Variation was documented and distance between landmarks and the SAN measured. The most common arrangement had the SST most superficially followed by the SBOA and then the SAN. The SAN was 3.63 \u00b1 4.02\u00a0mm from the artery and 2.31 \u00b1 1.72\u00a0mm from the tendon. A triangle\u2014bordered by the tendon laterally, artery medially, and digastric muscle superiorly\u2014contained the SAN in 95.8% of cases. This relationship translated into a reliable technique to identify the SAN intraoperatively, which has been used successfully in practice.<\/jats:p>","DOI":"10.1177\/0194599818766057","type":"journal-article","created":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T12:59:46Z","timestamp":1521550786000},"page":"300-302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Novel Approach to Identifying the Spinal Accessory Nerve in Surgical Neck Dissection"],"prefix":"10.1002","volume":"159","author":[{"given":"Michael James","family":"Eastwood","sequence":"first","affiliation":[{"name":"University Hospitals of North Midlands NHS Trust Stoke\u2010On\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajith Paulose","family":"George","sequence":"additional","affiliation":[{"name":"University Hospitals of North Midlands NHS Trust Stoke\u2010On\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1906.25210220006001a"},{"key":"e_1_2_8_3_1","first-page":"335","article-title":"Evolution of elective neck dissection in N0 laryngeal cancer","volume":"26","author":"Gallo O","year":"2006","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.6.662"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197206)29:6<1446::AID-CNCR2820290604>3.0.CO;2-C"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.7.751"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1961.00740030433011"},{"key":"e_1_2_8_8_1","first-page":"204","volume-title":"Cranial Nerves","author":"Wilson\u2010Pauwels L"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(09)60336-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2001.00396.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000154729.31281.da"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26573"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197905000-00022"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20796"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106000879"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.08.004"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221505774783511"},{"key":"e_1_2_8_18_1","first-page":"206","volume-title":"Grant's Dissector","author":"Tank PW"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2013-0069"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.12.1428"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.2.144"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22585"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818766057","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599818766057","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818766057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:36:11Z","timestamp":1760967371000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599818766057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,20]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1177\/0194599818766057"],"URL":"https:\/\/doi.org\/10.1177\/0194599818766057","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,20]]},"assertion":[{"value":"2017-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}