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Shoulder function in patients undergoing selective neck dissection with or without radiation and chemotherapy

Authors

  • Jeremy P. Watkins MD,

    1. Department of Otolaryngology – Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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  • Glenn B. Williams MD,

    Corresponding author
    1. Department of Otolaryngology – Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
    • Department of Otolaryngology – Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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  • Anthony A. Mascioli MD,

    1. Department of Orthopedic Surgery – Campbell Clinic, University of Tennessee Health Science Center, Memphis, Tennessee
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  • Jim Y. Wan PhD,

    1. Department of Preventive Medicine – University of Tennessee Health Sciences Center, Memphis, Tennessee
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  • Sandeep Samant MD

    1. Department of Otolaryngology – Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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Abstract

Background.

Shoulder function can be negatively affected during treatment of upper aerodigestive tract carcinoma. The purpose of this study was to investigate the impact of selective neck dissection alone or in combination with radiotherapy and/or chemotherapy.

Methods.

We conducted an observational study in adults who underwent selective neck dissection for the treatment of upper aerodigestive tract cancer who were >6 months from completion of their therapy. Recurrent disease and use of flap reconstruction were part of the exclusion criteria. A modified Constant's score was used to evaluate shoulder function.

Results.

Thirty-four patients (42 selective neck dissections) met the inclusion criterion. Operated shoulder function was significantly (p < .001) decreased as compared to the nonoperated shoulder. There was no statistical difference in the total Constant's score, in the subjective or objective scores among selective neck dissection only, in the selective neck dissection plus radiation therapy, or in the selective neck dissection plus chemoradiation therapy.

Conclusion.

Selective neck dissection can have a negative effect on shoulder function despite spinal accessory nerve preservation. Adjuvant therapy does not contribute additional detriment to shoulder function. © 2010 Wiley Periodicals, Inc. Head Neck, 2011

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