頚部腫りゅう切除後に副神経麻ひを生じた３例

Abstract

Three cases of accessory nerve injury after excision of the neck tumor were reported. Characteristic complains of these patients are shoulder pain, atrophy of the trapezius, and weakness of shoulder abduction.A 59-year-old female visited our hospital 7 months after excision of the right neck lipoma. She noticed pain, atrophy, weakness and inability to horizontally abduct the shoulder. Intraoperatively, the accessory nerve was found to be buried in the scar. Neurolysis was performed because muscle twitch was elicited by electrostimulation. She could horizontally abduct the shoulder 3 weeks after neurolysis and complete recovery was seen after 3 years and 3 months.A 27-year-old male was referred to our hospital, 2 months after excision of the right neck lymphnode. Intraoperative findings revealed a neuroma in-continuity of the accessory nerve. 7 months after resection of the neuroma and epineural repair, complete recovery was seen.A 36-year-old male visited our hospital, 2 months after excision of the right neck lymphnode. The accessory nerve was buried in the scar and one of three funiculi was tied. Resection of neuroma and funicular repair were performed in the funiculus and neurolysis was carried out in the other. Six months after surgery, muscle strength was recovered, but trapezius atrophy remained.