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Surgical exploration revealed compression of the SAN by enlarged lymph nodes. Neurolysis of the nerve was performed, resulting in significant clinical improvement. This case is significant for highlighting a rare cause of SAN palsy, adding to the scarce literature on non-iatrogenic origins of the condition.<\/jats:p>","DOI":"10.1136\/bcr-2025-268594","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:45:37Z","timestamp":1767789937000},"page":"e268594","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Non-iatrogenic spinal accessory nerve palsy due to lymph node compression"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0364-0760","authenticated-orcid":false,"given":"Ines Oliveira","family":"Pires","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery, ULS S\u00e3o Jos\u00e9, Lisbon, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardo","family":"Cavadas","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, ULS S\u00e3o Jos\u00e9, Lisbon, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerardo","family":"Millan","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Hospital da Luz Lisboa, Lisbon, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo","family":"Casal","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, ULS S\u00e3o Jos\u00e9, Lisbon, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"2026010704453183000_19.1.e268594.1","unstructured":"AlShareef S , Newton BW . 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