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Shoulder complaints after nerve sparing neck dissections.
C P van Wilgen1, P U Dijkstra, B F A M van der Laan
1Department of Oral and Maxillofacial Surgery, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. c.p.van.wilgen@rev.azg.nl
International Journal of Oral and Maxillofacial Surgery
|August 4, 2004
Summary
Neck dissection surgery can lead to shoulder complaints, with supraomohyoid neck dissection (SOHND) showing the lowest prevalence. Radiation therapy did not significantly impact these shoulder issues post-surgery.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Neck dissection is a common procedure for head and neck cancers.
- Shoulder dysfunction is a known complication following neck dissection.
- Nerve-sparing techniques aim to minimize functional deficits.
Purpose of the Study:
- To determine the prevalence of shoulder complaints one year after nerve-sparing neck dissection.
- To assess the impact of different neck dissection types on shoulder function.
- To evaluate the influence of adjuvant radiation therapy on shoulder complaints.
Main Methods:
- A cohort of 137 patients who underwent neck dissection (MRND, PLND, SOHND) were interviewed.
- Patients completed a shoulder disability questionnaire to quantify functional limitations.
- Statistical analysis was performed to correlate neck dissection type and radiation therapy with shoulder complaints.
Main Results:
- Shoulder complaints were reported by 33.3% after modified radical neck dissection (MRND), 66.7% after postero-lateral neck dissection (PLND), and 20% after supraomohyoid neck dissection (SOHND).
- The type of neck dissection was significantly associated with the occurrence of shoulder complaints (P < 0.001).
- Shoulder disability questionnaire scores also showed significant differences based on the type of neck dissection (P < 0.01).
- Radiation therapy did not demonstrate a significant effect on shoulder complaints or disability.
Conclusions:
- Supraomohyoid neck dissection (SOHND) is associated with a low prevalence of shoulder complaints and reduced daily activity disability.
- The type of neck dissection significantly influences the likelihood and severity of post-operative shoulder complaints.
- Adjuvant radiation therapy does not appear to exacerbate shoulder complaints or disability following nerve-sparing neck dissection.