{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:31:16Z","timestamp":1790361076529,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,4,10]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>The spinal accessory nerve (SAN) is an important cranial nerve encountered during neck dissection. Preservation of this nerve from iatrogenic damage is crucial to avoid debilitating sequalae, which can be made challenging due to variation of its anatomical course. In this case report, we present a patient who underwent supraomohyoid neck dissection, where a rare variation of a dual SAN, traversing the internal jugular vein midway, was encountered. In this case report, we study this anatomical finding, which is undoubtedly a valuable addition to the existing knowledge of the SAN. Ultimately, allowing surgeons to develop further awareness of the variations of the SAN and contributing to favourable postoperative outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2022-249866","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T11:43:18Z","timestamp":1682422998000},"page":"e249866","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Dual spinal accessory nerve: an anatomical anomaly during neck dissection"],"prefix":"10.1136","volume":"16","author":[{"given":"Faizan","family":"Shah","sequence":"first","affiliation":[{"name":"ENT, University Hospital Monklands, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabih Nadeem","family":"Qamar","sequence":"additional","affiliation":[{"name":"ENT, University Hospital Monklands, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehaab","family":"Jaffer","sequence":"additional","affiliation":[{"name":"ENT, University Hospital Monklands, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Crosbie","sequence":"additional","affiliation":[{"name":"ENT, University Hospital Monklands, Airdrie, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"2025082703282555000_16.4.e249866.1","first-page":"337","article-title":"Surgical anatomy of the spinal accessory nerve: is the great auricular point reliable?","volume":"38","author":"Chen","year":"2009","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2025082703282555000_16.4.e249866.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000041943.47622.EB"},{"key":"2025082703282555000_16.4.e249866.3","doi-asserted-by":"crossref","unstructured":"Suzuki H , Matsui Y , Iwai T , et al . Usefulness of ultrasonography for diagnosing iatrogenic spinal accessory nerve palsy after lymph node needle biopsy: a case report. BMC Musculoskelet Disord 2020;21. doi:10.1186\/s12891-020-03737-w","DOI":"10.1186\/s12891-020-03737-w"},{"key":"2025082703282555000_16.4.e249866.4","doi-asserted-by":"crossref","first-page":"518","DOI":"10.3171\/2014.12.SPINE14968","article-title":"Surgical outcomes of 156 spinal accessory nerve injuries caused by lymph node biopsy procedures","volume":"23","author":"Park","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"2025082703282555000_16.4.e249866.5","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1961.00740030433011"},{"key":"2025082703282555000_16.4.e249866.6","doi-asserted-by":"crossref","first-page":"899","DOI":"10.3233\/BMR-160674","article-title":"Spinal accessory nerve injury: a potentially missed cause of a painful, droopy shoulder","volume":"29","author":"Macaluso","year":"2016","journal-title":"J Back Musculoskelet Rehabil"},{"key":"2025082703282555000_16.4.e249866.7","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/02688697.2016.1187253","article-title":"Variations of the accessory nerve: anatomical study including previously undocumented findings-expanding our misunderstanding of this nerve","volume":"31","author":"Tubbs","year":"2017","journal-title":"Br J Neurosurg"},{"key":"2025082703282555000_16.4.e249866.8","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1590\/S1808-86942011000200017","article-title":"Spinal accessory nerve neuropathy following neck dissection","volume":"77","author":"Lima","year":"2011","journal-title":"Braz j Otorhinolaryngol (Impr)"},{"key":"2025082703282555000_16.4.e249866.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.07.005"},{"key":"2025082703282555000_16.4.e249866.10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00276-010-0737-y","article-title":"Anatomic relationship between the spinal accessory nerve and the jugular vein: a cadaveric study","volume":"33","author":"Saman","year":"2011","journal-title":"Surg Radiol Anat"},{"key":"2025082703282555000_16.4.e249866.11","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-235487","article-title":"Dual spinal accessory nerve: caution during neck dissection","volume":"13","author":"Danish","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2025082703282555000_16.4.e249866.12","doi-asserted-by":"crossref","first-page":"368","DOI":"10.14639\/0392-100X-844","article-title":"Spinal accessory nerve preservation in modified neck dissections: surgical and functional outcomes","volume":"37","author":"Popovski","year":"2017","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"2025082703282555000_16.4.e249866.13","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01769"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-249866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:28:35Z","timestamp":1756290515000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-249866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,25]]},"published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1136\/bcr-2022-249866"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-249866","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}