Accessory nerve injury.

A series of 13 patients with an injury of the accessory nerve in the posterior cervical triangle is reported. In 11 patients the nerve was damaged during a lymph node biopsy and in two cases there was a sharp glass injury. Paralysis of the trapezius muscle occurred with resulting deformity and loss of function of the shoulder. Nine patients were operated on. In five cases neurolysis, in two cases neurorrhaphy and in two cases reconstruction with a sural nerve graft were performed 3-17 months after the injury. The result was good or fair in six operative cases. Five of these were neurolyses. In one instance good and in three cases fair recovery was achieved without operation. All but one of the patients were able to return to their former employment. The mean follow-up time was 20 months.