Diagnostic Neuromuscular Ultrasonography of Spinal Accessory Nerve Injury After Cosmetic Rhytidectomy

Area of Science:

• Neurology
• Surgical Complications
• Medical Imaging

Background:

• Iatrogenic spinal accessory nerve (SAN) injuries are known complications following posterior neck surgery.
• These injuries can lead to significant functional deficits, including lateral scapular winging and shoulder droop.
• Such complications are infrequently reported after cosmetic rhytidectomy (face-lift procedures).

Observation:

• This report details two cases of iatrogenic SAN injuries occurring subsequent to cosmetic rhytidectomy.
• The patients presented with symptoms consistent with SAN damage after their procedures.
• The injuries were identified and evaluated using advanced diagnostic techniques.

Findings:

• Electrodiagnostic testing and ultrasound examinations were instrumental in diagnosing the SAN injuries.
• Electrodiagnostic studies confirmed the presence and severity of nerve damage.
• Ultrasound provided detailed anatomical insights, visualizing nerve continuity and muscle denervation.

Implications:

• This highlights the potential risk of SAN injury during cosmetic rhytidectomy, a previously underreported complication.
• The findings underscore the importance of utilizing electrodiagnostic and ultrasound assessments for diagnosing peripheral nerve injuries.
• These methods offer critical information for patient management and surgical technique refinement.