TRAUMATIC SPINAL ACCESSORY NERVE PALSY

Spinal accessory nerve sections due to a purely traumatic origin are v ery rare. The authors report a case in which a total section of the sp inal accessory nerve was observed after a glass-penetrating injury. Th e primary lesion was undiagnosed, and only late physical examination r evealed a scapula alata with a deficiency in shoulder protrusion and e levation. Surgical exploration with direct suturing of the nerve was p erformed 2 months after the initial trauma; full restoration of muscle function was obtained 12 months after the surgical procedure. Pain, t he dominant preoperative feature, totally disappeared after restoratio n of shoulder function. Although infrequent, spinal accessory nerve le sions must always be excluded in cases of penetrating injuries in the posterior triangle of the neck. Emphasis is placed on diagnosis and tr eatment of this condition.