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Upper limb dysfunction following selective neck dissection: a retrospective questionnaire study.

Simon D Carr1, Duncan Bowyer, Graham Cox

  • 1ENT Department, Leeds General Infirmary, Leeds, United Kingdom. simon_carr@hotmail.com

Head & Neck
|March 5, 2009
PubMed
Summary
This summary is machine-generated.

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Long-term upper limb dysfunction is common after selective neck dissection, even with nerve-preserving techniques. The Disability of Arm, Shoulder and Hand (DASH) questionnaire effectively assesses this dysfunction.

Area of Science:

  • Oncology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Selective neck dissection (SND) is a standard procedure for head and neck cancer.
  • Assessing long-term functional outcomes, particularly upper limb function, is crucial for patient quality of life.
  • Nerve preservation during SND aims to minimize functional deficits.

Purpose of the Study:

  • To evaluate total upper limb function after selective neck dissection.
  • To determine the prevalence and severity of upper limb dysfunction following SND.
  • To assess the utility of the DASH questionnaire in this patient population.

Main Methods:

  • Retrospective questionnaire study conducted in a tertiary head and neck surgical unit.
  • 148 patients who underwent SND for head and neck cancer between 2000 and 2005 were invited.

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  • The primary outcome measure was ipsilateral upper limb dysfunction assessed using the Disability of Arm, Shoulder and Hand (DASH) questionnaire.

    • Main Results:

    • 65 out of 148 invited patients responded (44% response rate).
    • Despite accessory nerve-conserving surgery, significant upper limb dysfunction was reported: 54% mild, 15% moderate, and 8% severe.
    • Only 23% of patients reported no upper limb dysfunction.

    Conclusions:

    • Long-term upper limb dysfunction is a frequent complication following selective neck dissection, even when nerve-preserving techniques are employed.
    • The DASH questionnaire is a valuable clinical tool for preoperative and postoperative assessment of upper limb function in patients undergoing SND.
    • Further research may explore specific interventions to mitigate long-term upper limb dysfunction.