Christine B Novak1, Susan E Mackinnon. 1. Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Abstract
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.
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.