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

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.