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Modified Radical Neck Dissection for Cervical Metastasis
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Postoperative neurocognitive function and microembolus detection in patients undergoing neck dissection: a pilot

Jörn Leiendecker1, Jan Höcker, Patrick Meybohm

  • 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. leiendecker@anaesthesie.uni-kiel.de

European Journal of Anaesthesiology
|April 16, 2010
PubMed
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Neck dissection surgery can cause early postoperative neurocognitive dysfunction (POCD) linked to cerebral microembolism and elevated S100beta protein. However, this cognitive deficit was not observed 12 months post-surgery.

Area of Science:

  • Neurosurgery
  • Neuroscience
  • Vascular Surgery

Background:

  • Oncologic neck dissection patients often have risk factors for carotid artery stenosis.
  • This predisposes them to perioperative cerebral ischemic events.

Purpose of the Study:

  • To investigate the development of postoperative neurocognitive dysfunction (POCD) in patients undergoing oncologic neck dissection.
  • To assess the long-term impact of neck dissection on cognitive function.

Main Methods:

  • A comprehensive neuropsychological test battery was used to assess 26 patients before surgery, 48 hours after, and at 12 months.
  • Cognitive performance was compared to a matched control group.
  • Doppler ultrasonography detected intraoperative cerebral microembolism, and S100beta protein levels were measured.

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Main Results:

  • 26.9% of neck dissection patients exhibited POCD on the second postoperative day.
  • Cerebral microemboli were detected exclusively in the neck dissection group.
  • S100beta protein levels were significantly elevated post-neck dissection, but POCD incidence was similar between groups at 12 months.

Conclusions:

  • POCD is detectable in the early postoperative period after neck dissection, associated with microembolism and increased S100beta.
  • The incidence of POCD after neck dissection returns to baseline levels by 12 months post-surgery.