Spinal accessory nerve injury after rhytidectomy (face lift): a case report.

Injury to the spinal accessory nerve can be a disabling disorder. Patients with a spinal accessory nerve injury may have pain, paresthesias, and motor weakness that may result in scapular winging. The nerve can be injured by open, penetrating, or closed trauma; however, the most common cause is iatrogenic. This is most commonly encountered after procedures in the posterior triangle of the neck such as radical neck dissection, lymph node dissection, or biopsy. It has been reported on a less frequent basis with procedures such as carotid endarterectomy and abscess drainage. We report the case of a 66-year-old woman who developed iatrogenic, postsurgical injury to the spinal accessory nerve after rhytidectomy (face-lift), which subsequently resulted in a painful weak shoulder girdle. We believe that it is important for upper extremity surgeons to be aware of this as a potential cause for scapular winging.