How is a spinal accessory nerve (SAN) injury evaluated?

Updated: Mar 04, 2020
  • Author: Rohan R Walvekar, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Evaluation of patients to detect SAN injury requires an organized clinical examination that may be supplemented with electrophysiologic nerve and muscle studies, as described in the Workup section. [26]

An understanding of the clinical presentation that arises from complete SAN resection during a radical neck dissection procedure gives insight into the spectrum of signs and symptoms that manifest during lesser injuries. The term "shoulder syndrome" is used to describe the pain and shoulder dysfunction that can follow radical neck dissection. [27] Most of the following presenting symptoms and signs are attributable to denervation of the upper trapezius muscle:

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