Abstract
Apart from complete surgical clearance of the malignancy, reducing morbidity and improving quality of life of the patient is also considered. One of the morbidities linked with neck dissections is shoulder dysfunction. The aim of our study is to analyse the functional outcomes in patients operated for various neck dissections with preservation of the Spinal accessory nerve. A single centre prospective observational study was conducted in a total of 45 patients with oral cancers. These patients underwent Wide local excision of the primary tumour along with neck dissection. Tests for assessing spinal accessory nerve function was elicited in all these patients preoperatively and postoperatively. Patients were examined for shoulder pain and shoulder disability using Arm abduction test. All 45 patients underwent spinal accessory nerve preserving neck dissection. On post operative day 10, 89% of patients showed arm abduction test score of 1 and 47% of patients had a pain score of 6 whereas 13% had a pain score of 8. After 6 months of rehabilitation and regular follow up, 62% of the patients had improved arm abduction test score of 4 and above and all 45 patients had pain score improved to score of 4 and less. Variable amount of shoulder dysfunction is seen even in spinal accessory nerve preserving neck dissections. But active rehabilitation and regular follow up of these patients reduces the morbidity associated with shoulder syndrome.
Similar content being viewed by others
References
Marchese C, Cristalli G, Pichi B, Manciocco V, Mercante G, Pellini R, Marchesi P, Sperduti I, Ruscito P, Spriano G (2012) Italian cross-cultural adaptation and validation of three different scales for the evaluation of shoulder pain and dysfunction after neck dissection: University of California - Los Angeles (UCLA) Shoulder Scale, Shoulder Pain and Disability Index (SPADI) 32(1):12–7
Kuntz AL, Weymuller EA (1999) Impact of neck dissection on quality of life. Laryngoscope 109(8):1334–8
Cheng PT, Lin YH, Hao SP, Yeh ARM (2000) Objective comparison of shoulder dysfunction after three neck dissection techniques. Ann Otol Rhinol Laryngol 109(8 Pt 1):761–6
Cappiello J, Piazza C, Giudice M, De Maria G, Nicolai P (2005) Shoulder disability after different selective neck dissections (levels II–IV versus levels II–V): a comparative study. Laryngoscope 115(2):259–63
Lea J, Bachar G, Sawka AM, Lakra DC, Gilbert RW, Irish JC et al (2010) Metastases to level IIb in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis. Head Neck 32(2):184–90
Paleri V, Subramaniam SK, Oozeer N, Rees G, Krishnan S (2008) Dissection of the submuscular recess (sublevel IIb) in squamous cell cancer of the upper aerodigestive tract: prospective study and systematic review of the literature. Head Neck 30(2):194–200
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article. Written, informed and valid consent was taken from all the patients.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Shah, K., Patekar, S., Ishwarya, M. et al. Shoulder Dysfunction Post Spinal Accessory Nerve Preserving Neck Dissections: Our Experience. Indian J Otolaryngol Head Neck Surg 75, 675–679 (2023). https://doi.org/10.1007/s12070-022-03393-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-022-03393-7