Upper limb dysfunction following selective neck dissection: A retrospective questionnaire study

Abstract

Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections.

Institutional experience with lateral neck dissections for thyroid cancer

“…18,19 In our study, spinal accessory nerve dysfunction was identified after 7 LNDs (6%); 6 temporary injuries resolved with short-term physical therapy (<3 months), and the 1 permanent injury, which occurred after a difficult reoperative LND, was still associated with deficits at last follow-up at 1 year. Variations in nerve branching, intercalation with the cervical plexus, and intraoperative misidentification of the eleventh nerve as the minor occipital nerve, likely contribute to increased rates of injury when LND is performed by less experienced surgeons.…”

“…Reoperation was curative in both patients and they were discharged on postoperative day 2. Chyle leak patients required drains for a median duration of 12 days (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], which was significantly longer than in patients without chyle leak (median, 6 days; range, 2-16; P < .01). There was no association found between drain duration and the risk of SSI.…”

Long-Term and Latent Side Effects of Specific Cancer Types

“…One study found that upper limb dysfunction was reported to some extent in 77% of patients. 76 Those with spinal accessory nerve palsy can undergo physical therapy to strengthen the affected shoulder to improve or maintain range of motion in the joint.…”

Posttreatment surveillance PET/CT for HPV‐associated oropharyngeal cancer

“…A repeat PET/CT or excisional biopsy may be reasonable alternatives to a selective neck dissection, which can entail underappreciated morbidity. Previous studies show that 9%‐25% of patients undergoing a selective neck dissection report shoulder pain and 77% develop some degree of upper limb dysfunction …”