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Related Experiment Videos

The 11th nerve syndrome in functional neck dissection.

Grazia Salerno1, Matteo Cavaliere, Alessandra Foglia

  • 1Department of Otorhinolaryngology, University Federico II, Naples, Italy. grazia.salerno@tin.it

The Laryngoscope
|August 10, 2002
PubMed
Summary

Postoperative physical therapy significantly reduces shoulder pain and dysfunction in patients after functional neck dissection and total laryngectomy. Early rehabilitation improves shoulder function and quality of life, aiding return to work.

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Area of Science:

  • Oncology
  • Rehabilitation Medicine
  • Surgical Outcomes

Background:

  • Functional neck dissection (FND) combined with total laryngectomy can lead to shoulder dysfunction.
  • Accessory nerve injury and immobility contribute to post-surgical shoulder disability.
  • Quality of life (QOL) is often impacted by shoulder complaints.

Purpose of the Study:

  • To assess shoulder joint disability incidence post-FND and total laryngectomy.
  • To evaluate the efficacy of a personalized postoperative physical rehabilitative protocol.
  • To determine the impact of therapy on pain, shoulder dysfunction, and QOL.

Main Methods:

  • Sixty patients undergoing FND and total laryngectomy were divided into two groups.
  • Group A received a specific postoperative physical therapy protocol; Group B did not.

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  • Clinical outcomes were assessed using the Constant questionnaire, range of motion, and quantitative electromyography (Q-EMG).

    • Main Results:

    • Group A demonstrated significantly better outcomes in passive/active shoulder motion, pain reduction, and QOL scores (P=0 and P<.001).
    • Multivariate analysis identified shoulder motility and Constant score as key predictors for pain and return to work.
    • Q-EMG showed initial deterioration followed by improvement in scapulohumeral muscles.

    Conclusions:

    • Post-surgical shoulder disability stems from accessory nerve injury, glenohumeral stiffness, muscle weakness, and immobility.
    • Early physical therapy is crucial for restoring passive motion and preventing joint fibrosis.
    • Rehabilitative protocols effectively decrease shoulder complaints and enhance patient QOL.