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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2001 April;12(1):25-32
“Shoulder syndrome” in neck dissection. Our experience
Tullio A., Raho M. T., Pavesi G. *, Cattaneo L. *, Sesenna E.
From the Department of Maxillo-Facial Surgery University of Parma, Parma
* Neurological Clinic, Parma Hospital
Background. The accessory nerve is studied in different types of neck dissection, pointing up the reduction of post-operative morbidity and in particular the reduced onset of the “shoulder syndrome” (pain, lowering and antero-rotation of the shoulder, reduced active abduction of the arm) in selective dissection versus comprehensive dissection.
Methods. Retrospective data from the Department of Maxillo-Facial Surgery, Parma, Italy were studied. The sample comprised 19 patients, divided into three groups: one had undergone radical dissection, one function excision and one supraomohyoid dissection. The study examined anamnesis, clinical and electromyographical data, at a distance of one, three and six months from surgery, in order to quantify any differences in terms of morbidity of the shoulder girdle, and the short-term shoulder function recovery, after the three types of treatment.
Results. Analysis of the series of cases showed an important difference in terms of morbidity between the three types of neck dissection: patients treated with supraomohyoid dissection were characterized by excellent anamnesis, clinical and electromyographical data, while those subjected to functional dissection showed more marked limitations; those who had undergone radical dissection had an even more marked deficit.
Conclusions. Examination at one, three and six months after surgery showed significant differences in the three groups of patients: those who had undergone supraomohyoid dissection recovered more rapidly and more completely than those subjected to the functional procedure, whereas patients subjected to radical dissection did not recover functionality.