A simple method of identifying the spinal accessory nerve

The spinal accessory nerve (nerve XI) constitutes a unique and readily encountered hazard in cutaneous and subcutaneous surgery of the head and neck. Presented is a simple method of using pinprick hyperaesthesia to accurately identify the course of this nerve. Delineating this nerve prior to performing surgery in the lateral neck and shoulder region is crucial to avoid the potentially disastrous complication of severing this nerve.