Vol.101 No.11 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 11 November 2008
A Lateral Cervical Cyst with Paralysis of the Accessory
Nerve Caused by Percutaneous Ethanol Injection Therapy
Takehiro Iki, Kazuhiko Shoji, Tsuyoshi Kojima,
Atsuhito Takahashi and Masanobu Mizuta
(Tenri Hospital)
We experienced a patient with a lateral cervical cyst that was unsuccessfully resolved by treatment with percutaneous ethanol injection therapy (PEIT) at another hospital. Paralysis of the accessory nerve subsequently occurred as a direct result of PEIT, and we successfully treated this surgically. The patient, a 35-year-old male, had a swelling in his left upper neck. This swelling was diagnosed as a lateral cervical cyst, and PEIT was administered. After PEIT, he experienced pain in his left upper neck and difficulty in moving his left arm. The complaint persisted for several weeks had passed, and so he consulted Tenri hospital. His left upper neck was swollen and muscle of his left shoulder was atrophic. Sonography revealed that the cyst remained, and an MRI and electromyogram indicated denervation of his trapezius. An operation was conducted to remove the cyst. It adhered to the jugular vein and accessory nerve, but was successfully removed without damaging either structure.
Recently, PEIT has been applied for cervical cysts. It has an advantage over surgical methods because it doesn't require a skin incision, but it should be noted that ethanol injections may cause some irreversible complications, such as observed in this case.
Key words :lateral cervical cyst, paralysis of accessory nerve, PEIT