0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The 11th Nerve Syndrome:  Accessory Nerve Palsy or Adhesive Capsulitis?

Carolynn Patten, MSPT; Allen D. Hillel, MD
Arch Otolaryngol Head Neck Surg. 1993;119(2):215-220. doi:10.1001/archotol.1993.01880140105016.
Text Size: A A A
Published online

• The 11th nerve syndrome classically involves the majority of patients undergoing neck dissections even when the accessory nerve is preserved. A preliminary analysis of our data of 31 of 44 patients who underwent neck dissections from a prospective study showed numerous findings of shoulder disability that are not attributable to accessory nerve palsy but are well described by the syndrome of adhesive capsulitis of the glenohumeral joint. At 1 month postoperatively, although accessory nerve palsy symptoms were common, adhesive capsulitis symptoms were significant. At 6 months, the frequency of accessory nerve palsy symptoms was less as the accessory nerve had begun to recover. At 12 and 18 months, when most of the accessory nerves had recovered, the accessory nerve palsy symptoms were comparatively uncommon while the adhesive capsulitis symptoms predominated as the remaining symptoms of the 11th nerve syndrome. We propose that adhesive capsulitis is a principal component of the 11th nerve syndrome that can significantly compound the morbidity of a neck dissection even when the accessory nerve recovers. We also propose that adhesive capsulitis accounts for the persistence and variability of shoulder symptoms after neck dissection that cannot be attributed to trapezius muscle dysfunction.

(Arch Otolaryngol Head Neck Surg. 1993;119:215-220)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();