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Quantifying Neck Disability After Neck Dissection in HNSCC-A Prospective Study of Patient-Reported and Objective

Hongli Zhang1, Fujiang Wang2, Minjie Gu2

  • 1Department of Rehabilitation, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, China.

Head & Neck
|December 9, 2025
PubMed
Summary
This summary is machine-generated.

Neck dissection for head and neck cancer causes lasting disability. Surgical extent and chemotherapy predict worse outcomes, highlighting the need for tailored rehabilitation.

Keywords:
head and neck squamous cell carcinomaneck dissectionpatient reported outcome measuresquality of lifespinal accessory nerve

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Area of Science:

  • Oncology
  • Rehabilitation Medicine
  • Surgical Outcomes

Background:

  • Neck dissection is crucial for head and neck squamous cell carcinoma (HNSCC) treatment.
  • It frequently leads to significant postoperative neck disability.
  • Understanding functional recovery is key for patient management.

Purpose of the Study:

  • To prospectively assess the long-term functional outcomes after neck dissection for HNSCC.
  • To quantify patient-reported and objective measures of neck disability.
  • To identify predictors of persistent functional deficits.

Main Methods:

  • A prospective cohort of 178 HNSCC patients undergoing neck dissection.
  • Assessment of Neck Disability Index (NDI), pain (VAS), function (PSFS), range of motion (CROM), muscle strength (MMT), and nerve function (SAN) preoperatively and at 3, 6, 12 months.
  • Statistical analysis to identify predictors of disability.

Main Results:

  • At 12 months, functional outcomes did not return to baseline; 22.7% had severe disability (NDI > 25).
  • Radical neck dissection, dissection of levels IV/V, and chemotherapy predicted severe disability.
  • Spinal accessory nerve dysfunction affected 42% of patients; strong correlations existed between subjective and objective measures.

Conclusions:

  • Neck dissection causes persistent functional disability, influenced by surgical extent and chemotherapy.
  • The correlation between patient-reported and objective findings emphasizes the need for integrated assessment.
  • Tailored, multidisciplinary rehabilitation is essential to minimize long-term morbidity.