• Attilio Carlo Salgarelli, Barbara Landini, Pierantonio Bellini, Alessandra Multinu, Ugo Consolo, and Marco Collini.
• Oral and Maxillofacial Unit, Head and Neck Dipartiment, Universital Hospital of Modena and Reggio Emilia, Modena, Italy. attiliocarlo.salgarelli@unimore.it
• Oral Maxillofac Surg. 2009 Jun 1;13(2):69-72.

PurposeThe major complication of neck dissection and surgery at the posterior triangle of the neck is the shoulder syndrome, which results from spinal accessory nerve injury. Erb's point (the great auricular nerve) and the point where the spinal accessory nerve enters the trapezius muscle are used to identify the spinal accessory nerve in the posterior nerve triangle.Materials And MethodsMeasurements were made during unilateral neck dissections in 30 patients to identify the relationship between the spinal accessory nerve and great auricular nerve and the distance between the entrance of the accessory nerve in the trapezious and clavicle.ResultsThe distance between the spinal accessory nerve and Erb's point was ranging from 0 to 3.8 cm (mean 1.53 cm). The distance between the spinal accessory nerve entering the trapezious muscle and the clavicle was between 2.5 and 7.3 cm (mean 4.8 cm).ConclusionsSince the great auricular nerve (Erb's point) represents a constantly identifiable landmark, it allows simple and reliable identification of the course of the spinal accessory nerve. Also useful, but of secondary importance in our opinion, is identifying the nerve at the point where it enters the trapezius muscle.

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