Shoulder Dysfunction after Selective Neck Dissection in Recurrent Nasopharyngeal Carcinoma

Area of Science:

• Oncology
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Recurrent nasopharyngeal carcinoma (NPC) poses treatment challenges.
• Selective neck dissection (SND) is a surgical option for N0 recurrent NPC.
• Assessing the impact of SND on shoulder function is crucial.

Purpose of the Study:

• To determine the incidence of occult nodal metastasis in N0 recurrent NPC patients undergoing SND.
• To evaluate the severity and persistence of shoulder dysfunction post-SND.
• To inform surgical decision-making for recurrent NPC.

Main Methods:

• Prospective study of 46 patients with recurrent NPC (N0 status).
• Patients underwent salvage nasopharyngectomy and SND (levels I-III, V).
• Shoulder function assessed using the DASH questionnaire post-physiotherapy.

Main Results:

• Occult nodal metastasis incidence was 15.2%.
• Mean DASH scores remained high (44.2 at year 1, 46.3 at year 2).
• No significant improvement in shoulder function was observed despite physiotherapy.

Conclusions:

• SND for recurrent NPC leads to significant and persistent shoulder dysfunction.
• The low rate of microscopic nodal metastasis does not justify routine SND in this context.
• SND should be carefully considered due to functional deficits.