A Case of Accessory Nerve Injury during Lymph Node Biopsy in the Posterior Cervical Triangle

Abstract

A 29-year-old male visited our Dermatology Department with a complaint of a subcutaneous mass in the posterior cervical triangle. Because ultrasonography suggested that the mass was a lymph node in the superficial subcutaneous tissue, he underwent biopsy of the mass under local anesthesia. Soon after the biopsy, he suffered pain in the left upper arm and an inability to abduct the arm beyond 90°. Iatrogenic accessory nerve injury was diagnosed at the Orthopedic Department. Nerve suturing was performed 78 days after the biopsy, and the patient had fully recovered by seven months after the nerve repair. In order to avoid iatrogenic accessory nerve injury and its associated medical complications, it is important to understand that medical accidents can occur during surgery in the posterior cervical triangle. Medical practice on this area is mainly handled by otolaryngologists, and it is important to refrain from promptly scheduling any examinations or operations in the Dermatology Department. Before any surgery, informed consent should be obtained after providing a sufficient explanation of the potential complications of such surgery.