International Journal of Advanced Community Medicine
Vol. 2, Issue 3, Part A (2019)
Shoulder syndrome after neck dissection in patients with malignancies in the maxillofacial area
Author(s): Zornitsa Mihaylova
Abstract:Objective: Neck dissections are surgical interventions where lymph nodes from specific areas of the neck, together with non-lymphatic structures – sternocleidomastoid muscle, internal jugular vein and accessory nerve are removed. Important anatomical structures could be damaged during the surgery, causing postoperative complications associated with impaired function of the musculoskeletal system of the shoulder. The aim of the present study is to determine the degree of impairment in shoulder movements (motor function), depending on the volume of surgery in neck dissection. Methods:Constant Shoulder Score (CSS) was used to evaluate the motor function of the operated patients. The results obtained were analyzed by SPSS Vers23.0. Results:A statistically significant difference was found F (2,65) = 167,733, p<0.001, for the motor function of the shoulder in the three groups of neck dissection. A Tukey post hoc test was conducted to show that the arithmetic mean of the CS scale for radical neck dissection (RND) (X = 42.90) was statistically significantly different from the arithmetic mean of the supraomohyoid neck dissection (SOHND) groups (X = 66.50) and selective neck dissection (SND) (X = 67.14). The SOHND group was not statistically significantly different from the SND group. Conclusion:Analysis of the motor function of the shoulder shows its involvement in all neck dissections. At the 6th month postoperatively, a pronounced morbidity in all patients was determined following neck dissection.