Quality of Life After Neck Dissection

Inoue, Hiroyuki; Nibu, Ken‐ichi; Saito, Miki; Otsuki, Naoki; Ishida, Hirotaka; Onitsuka, Tetsuro; Fujii, Takashi; Kawabata, Kazuyoshi; Saikawa, Masahisa

doi:10.1001/archotol.132.6.662

Cited by 130 publications

(93 citation statements)

References 16 publications

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“…Extensive LND has the potential to decrease regional recurrence and increase disease‐free survival, but may lead to clinically important postoperative morbidities 13, 14, 15. Therefore, determining a rational extent of therapeutic LND is vital.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the above reasons and the prognostic significance, it is universally agreed that therapeutic LND should include at least a comprehensive but selective LND of levels II–IV. However, whether therapeutic LND should routinely include level V lymphadenectomy remains controversial 13, 14, 15, 16, 17, 18, 19, 20, 21, 22.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of postoperative morbidity (especially injury to the spinal accessory nerve and cervical plexus) that can lead to increased morbidity and affect the quality of life increases with the extent of LND. Therefore, the necessity of routine level V dissection has been questioned 13, 14, 15. Furthermore, because level V LNM are comparatively rare, some researchers have suggested that routine level V dissection is not necessary for patients with PTC and lateral cervical lymphadenopathy 16, 17, 18.…”

Section: Discussionmentioning

confidence: 99%

“…However, determining the appropriate extent of LND remains controversial. Radical operations, such as those with increased extent of LND, may lead to clinically important postoperative morbidities (shoulder dysfunction, neck numbness, and neuropathic pain) because of injury to the spinal accessory nerve or the cervical plexus despite gross preservation of these nerves 13, 14, 15. Therefore, an oncologically effective therapeutic LND is critical to postoperative outcome.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

et al. 2016

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The extent of lateral neck dissection (LND) in surgical resection of papillary thyroid carcinoma (PTC) with clinically lateral LNM (LLNM) remains controversial. We aimed to explore the frequency of and risk factors for level V LNM in patients with solitary PTC and clinically LLNM. To analyze the frequency and risk factors for level V LNM, we retrospectively reviewed 220 solitary PTC patients who underwent total thyroidectomy, bilateral central neck dissection, and therapeutic LND. LLNM were present in 82.3% patients, and levels II–V LNM were present in 45.9%, 62.7%, 55.5%, and 12.3% patients, respectively. Ipsilateral level V LNM was significantly associated with tumor size >10 mm, extrathyroidal extension, ipsilateral central LNM ratio ≥50%, and contralateral central LNM (CLNM), bilateral CLNM, and simultaneous levels II–IV LNM. Contralateral CLNM was an independent risk factor for level V LNM. In patients with solitary PTC and clinically LLNM, level V LNM was relatively uncommon. Therefore, routine level V lymphadenectomy may be unnecessary in these patients unless level V LNM is suspected on preoperative examination or associated risk factors, especially contralateral CLNM, are present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

et al. 2016

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“…The cutting of the sternocleidomastoid muscle and/or that of the spinal accessory nerve had a significant impact on daily activities, work and leisure activities 18 . dijkstra et al reported that the shoulder pain was clinically present in 70% of the patients after the nd surgery 19 .…”

Section: Discussionmentioning

confidence: 99%

Spinal accessory nerve neuropathy following neck dissection

Lima¹,

Amar²,

Lehn³

2011

Braz. j. otorhinolaryngol. (Impr.)

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Tt he most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle.Aim: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection.Materials and methods: prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. nerve integrity was evaluated before and after the surgery by means of surface eMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/ atrophy of the trapezius muscle.Results: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (p<0.001). There was a mean decrease of 70% comparing to preoperative values. The median was 12.5 microV after dissection including level iib, and 8.9 microV after dissection including levels iib and V (p<0.002). Conclusion:Surface eMG is a sensitive and painless method for spinal accessory nerve dysfunction evaluation. The results suggest the usefulness of the trapezius muscle electromyography to confirm diagnosis and early physical therapy intervention in neuropathies of the spinal accessory nerve. Braz J Otorhinolaryngol. 2011;77(2):259-62. ORIgInAL ARTIcLE BJORL

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Predictors of Level II and Vb Neck Disease in Metastatic Papillary Thyroid Cancer

Merdad

Eskander

Kroeker³

et al. 2012

Arch Otolaryngol Head Neck Surg

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Quality of Life After Neck Dissection

Abstract: To assess the impact of modifications to radical neck dissection on postoperative quality of life.Design: Cross-sectional study using a self-administered neck dissection questionnaire and an arm abduction test.

Cited by 130 publications

References 16 publications

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

Risk factors for level V lymph node metastases in solitary papillary thyroid carcinoma with clinically lateral lymph node metastases

Spinal accessory nerve neuropathy following neck dissection

Predictors of Level II and Vb Neck Disease in Metastatic Papillary Thyroid Cancer

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