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October 1991

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

Arch Otolaryngol Head Neck Surg. 1991;117(10):1084. doi:10.1001/archotol.1991.01870220022007

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Carolynn Patten, MD, Seattle, Wash, presented a study examining the role of adhesive capsulitis of the glenohumeral joint in the 11th nerve syndrome, which is frequently suffered by patients who have undergone a neck dissection. Forty-four patients were evaluated prospectively; 31 were found to have the classic symptoms of shoulder droop, pain, and limited active range of motion in lateral abduction of the arm. Of this group of patients, 71% to 83% were found to have physical abnormalities related to pathologic changes of the glenohumeral joint (adhesive capsulitis) rather than neuromuscular deinnervation from injury to the spinal accessory nerve. Recovery from symptoms of adhesive capsulitis were also found to be more prolonged.

The observations from this work are quite important. It confirms the belief that the 11th nerve syndrome is more than a neuromuscular problem, implying the importance of physiotherapy and other measures to treat the glenohumeral joint component of

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