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Of the Article: Comprehensive Study on Functional Outcome after Neck Dissection (Preserving Spinal Accessory Nerve)
Nidhish Rajesh Shah1, Girish Mishra1, Yojana Sharma1
1Department of ENT and head and neck surgery, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat India.
Introduction:
Head and neck cancers in India comprise nearly 30% of cancer cases, present diagnostic and therapeutic challenges. Neck dissection aims to improve survival outcomes. However, it can lead to complications like shoulder dysfunction, even when the spinal accessory nerve is preserved. Patient-reported outcomes, such as the QuickDASH, are essential in evaluating how these complications affect daily life postoperatively. This study evaluates functional outcomes using QuickDASH, contributing insights to postoperative care.
Aim:
To measure the functional outcome after Neck Dissection (preserving spinal accessory nerve) in patients undergoing the head & neck oncosurgeries.
Materials And Methods:
In this 14-month observational prospective study, 173 patients who underwent SAN-preserving neck dissections were followed. Postoperative care included physiotherapy, high-protein diet, and standard treatment protocols. Functional outcomes were measured at 6 weeks and 6 months post-surgery using QuickDASH. Statistical analysis included descriptive statistics, T-tests, ANOVA, and Chi-square tests, with a significance level of p < 0.05. Data were analyzed using STATA 14.2.
Results:
Oral cavity squamous cell carcinoma (OSCC) was the most common diagnosis, representing 85% of cases, with 62% presenting at an advanced stage. The SOHND group exhibited the best functional outcomes at 6 months. Patients with early-stage tumors and those who received postoperative physiotherapy demonstrated improved recovery, while free flaps yielded better shoulder functionality.
Conclusion:
Despite preserving anatomical integrity, patients often experience upper extremity dysfunction post-surgery, indicating nerve trauma. Immediate postoperative physiotherapy and high protein diet enhances functional recovery, as indicated by improved QuickDASH scores. QuickDASH can be used to identify patients at risk for shoulder dysfunction after neck dissection.
