# The use of ultrasound in the diagnosis of a ligated spinal accessory nerve with sural graft repair

## TL;DR

This case report shows how ultrasound can help diagnose a damaged spinal accessory nerve after surgery.

## Contribution

The paper highlights the novel use of ultrasound in identifying stump neuromas of the spinal accessory nerve.

## Key findings

- Ultrasound successfully identified a damaged spinal accessory nerve in a patient post-lymph node biopsy.
- A sural graft repair was performed for both the spinal accessory nerve and the greater auricular nerve.
- The case emphasizes ultrasound's diagnostic potential for nerve injuries in the neck.

## Abstract

The extra-cranial spinal accessory nerve (SAN) is an important motor nerve, responsible for innervating the trapezius and sternocleidomastoid muscle (SCM). At a particular point in the neck SAN is vulnerable to iatrogenic injuries, particularly during lymph neck node dissection. We present the radiological and clinical features of a 29 year old female sickle cell patient who was referred for an ultrasound assessment of a suspected injured SAN following an excisional lymph node biopsy. A sural graft repair was subsequently preformed of both SAN and the greater auricular nerve (GAN). This case report aims to promote the diagnostic capabilities of ultrasound in identifying stump neuromas, specially relating to the SAN.