Patient outcome after surgical management of an accessory nerve injury.
OBJECTIVE
This study assessed patient outcome following surgical reconstruction of the accessory nerve after an iatrogenic injury.


METHODS
A retrospective chart review of 8 patients was performed.


RESULTS
There were 3 men and 5 women in the study, and the mean time between injury and nerve graft/repair surgery was 5 months. Four injuries were sustained during a lymph node biopsy. Electromyography revealed a complete accessory nerve injury in all cases. In 6 cases, a nerve graft was required (mean length, 3.6 cm), and in 2 cases, a direct nerve repair was possible. The trapezius muscle was successfully reinnervated in all cases. In total, full shoulder abduction was achieved in 6 cases; in the remaining 2 cases, the patients achieved shoulder abduction to 90 degrees.


CONCLUSIONS
Functional deficit after accessory nerve injury is significant. Nerve graft/repair reconstruction reliably yields a satisfactory result, providing good scapular rotation and thus good shoulder function.
Novak
Christine B
CB
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Mackinnon
Susan E
SE
D000055:Accessory Nerve / Q000601:surgery*; D061227:Accessory Nerve Injuries; D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012399:Rotation; D012540:Scapula / Q000294:innervation*; D012782:Shoulder / Q000294:innervation* / Q000502:physiology; D016896:Treatment Outcome