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Investigations into shoulder function after radical neck dissection.

V Fialka1, K Vinzenz

  • 1Institute of Physical Medicine, University of Vienna, Austria.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|April 1, 1988
PubMed
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Radical neck dissection can impair shoulder function, particularly the trapezius muscle. Electromyography (EMG) helps assess this damage, and physical therapy shows promise for recovery.

Area of Science:

  • Oncology
  • Neurosurgery
  • Physical Medicine and Rehabilitation

Background:

  • Radical neck dissection (RND) is a surgical procedure for head and neck cancers.
  • RND can lead to significant shoulder dysfunction due to potential damage to the spinal accessory nerve and trapezius muscle.
  • Postoperative physical therapy is often recommended, but its efficacy needs further evaluation.

Purpose of the Study:

  • To assess shoulder function following radical neck dissection.
  • To evaluate the effectiveness of postoperative physical treatment.
  • To correlate clinical findings with electromyographic results.

Main Methods:

  • Clinical examination of the shoulder girdle in 43 patients post-RND.
  • Electromyographic (EMG) testing of the trapezius muscle.

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  • Assessment conducted 10 days to 1 month after surgery.

    • Main Results:

    • A correlation was found between muscle atrophy extent and clinical shoulder parameters (e.g., abduction, scapular displacement).
    • EMG indicated primary damage to the descending trapezius fibers, with less damage to the ascending fibers.
    • EMG is a valuable tool for determining the clinical status post-RND.

    Conclusions:

    • Shoulder function assessment after RND is crucial.
    • EMG provides objective data on trapezius muscle integrity.
    • Physical therapy may be effective for managing persistent shoulder disability after RND.