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Functional assessment using Constant's Shoulder Scale after modified radical and selective neck dissection
Douglas B Chepeha1, Rodney J Taylor, Judith C Chepeha
1Department of Otolaryngology-Head & Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Taubman Center 1904, Ann Arbor 48109-0312, USA. dchepeha@umich.edu
Background:
Constant's Shoulder Scale is a validated and widely applied instrument for assessment of shoulder function. We used this instrument to assess which treatment and demographic variables contribute to shoulder dysfunction after neck dissection in head and neck cancer patients.
Methods:
A convenience sample of 54 patients with 64 neck dissections and minimum follow-up of 11 months were evaluated. Thirty-two accessory nerve-sparing modified radical (MRND) and 32 selective neck (SND) dissections were performed. Multivariable regression analysis was used to determine the variables that were predictive for shoulder dysfunction. Clinical variables included age, time from surgery, handedness, weight, radiation therapy, neck dissection type, tumor stage, and site.
Results:
Patients receiving MRND had significantly worse shoulder function than patients with SND (p =.0007). Radiation therapy contributed negatively, whereas weight contributed positively (p =.0001).
Conclusions:
The critical factors contributing to shoulder dysfunction after neck dissection were weight, radiation therapy, and neck dissection type.