ORIGINAL ARTICLES   

Rivista Italiana di Chirurgia Maxillo-Facciale 2001 April;12(1):25-32

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

“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.