Ultrasonography of the accessory nerve: normal and pathologic findings in cadavers and patients with iatrogenic accessory nerve palsy.
OBJECTIVE
To determine feasibility of ultrasonography in detecting the normal accessory nerve as well as pathologic changes in cases of accessory nerve palsy.


METHODS
Four patients with accessory nerve palsy were investigated by ultrasonography. Three cases of accessory nerve palsy after lymph node biopsy and neck dissection were primarily diagnosed on the basis of ultrasonography using a 5- to 12-MHz linear transducer. In addition, we performed ultrasonography in 3 cadaveric specimens to show the feasibility of detecting the accessory nerve.


RESULTS
Nerve transection (n = 2), scar tissue (n = 1), and atrophy of the trapezius muscle (n = 4) were confirmed by electroneurographic testing and surgical nerve inspection. In 1 case in which a patient had a whiplash injury with accessory nerve palsy, ultrasonography showed atrophy of the trapezius muscle with a normal nerve appearance.


CONCLUSIONS
Ultrasonography allows visualization of the normal accessory nerve as well as changes after accessory nerve palsy.
D000055:Accessory Nerve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000473:pathology; D020436:Accessory Nerve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D005240:Feasibility Studies; D006801:Humans; D007049:Iatrogenic Disease; D008197:Lymph Node Excision / Q000009:adverse effects; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology; D009133:Muscular Atrophy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D009333:Neck / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology / Q000601:surgery; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000209:etiology; D010243:Paralysis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D014463:Ultrasonography; D014911:Whiplash Injuries / Q000150:complications