TRAUMATIC LESIONS OF THE SPINAL ACCESSORY NERVE .2. A CLINICAL-STUDY

Introduction Trapezius muscle paralysis after accessory nerve injury was mostly seen after a so called minor surgery of the neck: 17 lesions among 25 appeared after the excision of a cervical cyst or a small benign tumor. This notion should be remembered because the prevention of this paralysis is easy. Material and methods In the established lesion, the repair is to be done as soon as possible. The authors report a retrospective study of 25 cases of traumatic accessory nerve injury, followed from 1983 and 1992. A nerve repair was done in 15 cases. It consisted in an average 5 centimeters graft in 10 cases, an intramuscular neurotization in 4 cases, a direct suture in 1 case, and a neurolysis in 6 cases. A palliative treatment was suggested in 4 cases. Results The mean follow up was 15 months (range 6 to 57 months) and 22 operated cases had more than a 1 year follow up. We observed 10 good results for 10 grafts, 1 good result after 1 direct suture; the 4 neurotisations has 3 good results and 1 average result; the 6 neurolysis had 1 very good, 4 good and 1 poor results and in one case there was no possibility of repair. Discussion and conclusion The authors underline the good results after nerve repair following a lesion near from the paralysed muscle and also the need for prevention.