[Physiotherapy and diagnosis of shoulder lesions after radical neck dissection]

We examined 43 patients to study the influence of postoperative physiotherapy of shoulder disfunctions after radical neck dissection. We also wanted to elucidate the problem of the controversially documented multiple supply of this area by the cervical plexus. Shoulder function was examined clinically and by electrophysiology. Our results demonstrate that the degree of shoulder disfunction correlated well with clinical parameters like abduction in the frontal plane and lateral scapular movements. In all three muscular segments lesions were detected by electrophysiological tests. The majority of patients showed only minor impairment or normal results in the lower segment, which would point to a double or single enervation from the branches of the cervical plexus. These results confirm the value of postoperative physiotherapy for the treatment of shoulder disfunction. The study parameters are also important to assess the success of physiotherapy and to confirm its efficacy in cases of postoperative accessory nerve palsy.