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.

STUDY DESIGN

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.

CONCLUSION

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.