Neck and shoulder function in patients treated for oral malignancies: A 1‐year prospective cohort study

Speksnijder, Caroline M.; Bilt, Andries van der; Slappendel, M.A.; Wijer, Anton de; Merkx, Matthias A.W.; Koole, R.

doi:10.1002/hed.23131

Cited by 33 publications

(48 citation statements)

References 45 publications

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“…Others have shown that disability improved with time, and rehabilitation played an important role in promoting function and reducing pain. 9,[21][22][23][24] Some studies have focused on wrist mobility, but the effect of RFF flap harvest on this parameter is unclear. [7][8][9][10] In addition, it has been shown that objective measurements do not accurately reflect the patient's experience.…”

Section: Discussionmentioning

confidence: 99%

Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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Objective: To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Methods: Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Results: Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.93 AE 5.54; n ¼ 52) compared with those undergoing non-RFF flap surgeries (2.95 AE 4.42; n ¼ 52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Conclusion: Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.

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Section: Discussionmentioning

confidence: 99%

Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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“…Up to one year after surgery, previous studies show patients undergoing nerve sparing surgery have limitations in shoulder flexion and abduction ranging from 140–160 degrees, while those with nerve sacrificing surgery are often limited to less than 140 degrees of flexion or abduction. 7,21,23,24,36 In our study, subjects with nerve sparing surgery have fewer limitations in ROM compared to nerve sacrifice. However, average ROM measurements are slightly lower in our cohort of 5-year survivors than previous studies of 1-year survivors.…”

Section: Discussionmentioning

confidence: 57%

“…Other studies have found reduced cervical motion, which degrades QOL and upper body function. 23 We did not include electromyography to delineate the occurrence of muscle denervation or signs of reinnervation in the trapezius. 21 Future studies should also include a measure of psychological depression to assess the effect of mood disorder on QOL.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life, Shoulder Range of Motion, and Spinal Accessory Nerve Status in 5‐Year Survivors of Head and Neck Cancer

Eickmeyer

Walczak

Myers

et al. 2014

PM&R

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Objective To determine the association of neck dissection and radiation treatment for head and neck cancer (HNC) with subsequent shoulder range of motion (ROM) and quality of life (QOL) in 5-year survivors. Design Cross-sectional convenience sample Setting Otolaryngology clinics at tertiary care hospital and Veterans Affairs medical center Patients 5-year, disease-free, HNC survivors Methods Demographic and cancer treatment information was collected, including type of neck dissection (none, spinal accessory “nerve sparing” and “nerve sacrificing”) and radiation. QOL questionnaires were administered, and shoulder ROM was measured. Main Outcome Measurements University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy Head and Neck (FACT-HN), and Performance Status Scale for Head and Neck (PSS-HN). Shoulder ROM measurements included abduction, adduction, flexion, extension, internal and external rotation. Results One hundred and five survivors completed QOL surveys; 85 survivors underwent additional shoulder ROM evaluations. The nerve sacrifice group exhibited significantly poorer scores for UWQOL measures of disfigurement, level of activity, recreation/entertainment, speech, shoulder disability, and willingness to eat in public, FACT functional well-being, and FACT-HN (p<.05). Shoulder ROM for flexion and abduction was poorest in the nerve sacrifice group (p<.05). Radiation was associated with significantly worse UWQOL swallowing (p<.05), but no other differences were found for QOL or ROM measurements. Decreased QOL scores were associated with decreased shoulder flexion and abduction (p<.05). Survivors with decreased shoulder abduction had significantly (p<.05) worse scores in disfigurement, recreation/entertainment, employment, shoulder disability, and FACT emotional well-being. Conclusions Sparing the spinal accessory nerve during neck dissection is associated with significantly less long-term shoulder disability in 5-year HNC survivors. QOL measures demonstrated the highest level of function in the no dissection group, an intermediate level of functioning with nerve sparing, and poorest function when the nerve is sacrificed. Decreased shoulder flexion and abduction is associated with reduced QOL in long-term HNC survivors.

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“…En cas de nécessité de section du nerf spinal pour des raisons carcinologiques, la conservation des racines du plexus cervical permet de limiter les douleurs [11] (niveau de preuve 4). Lorsque le nerf spinal est conservé, la limitation de l'extension du curage permet de diminuer les douleurs postopératoires [12] (niveau de preuve 4), surtout lorsque les aires ganglionnaires situées au contact du nerf spinal (IIB et V) sont épargnées [13][14][15] (niveau de preuve 4). Le monitoring du nerf spinal pendant la chirurgie cervicale n'a pas fait la preuve d'un intérêt pour diminuer les douleurs postopératoires [16] (niveau de preuve 4).…”

Section: Douleurs Séquellaires De La Chirurgie Ganglionnaireunclassified

Prise en charge des douleurs somatiques induites par les traitements des cancers des voies aéro-digestives supérieures : la douleur post-chirurgicale. Recommandation de la Société française d’oto-rhino-laryngologie et de chirurgie de la face et du cou

Blanchard

Bollet

Dreyer

et al. 2014

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Ce

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Neck and shoulder function in patients treated for oral malignancies: A 1‐year prospective cohort study

Abstract: Neck dissection, tumor site, and extensive reconstruction are related to deterioration of shoulder function shortly after intervention. Maximal active shoulder abduction was affected most.

Cited by 33 publications

References 45 publications

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Quality of Life, Shoulder Range of Motion, and Spinal Accessory Nerve Status in 5‐Year Survivors of Head and Neck Cancer

Prise en charge des douleurs somatiques induites par les traitements des cancers des voies aéro-digestives supérieures : la douleur post-chirurgicale. Recommandation de la Société française d’oto-rhino-laryngologie et de chirurgie de la face et du cou

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