Morbidity of supraomohyoidal and modified radical neck dissection combined with radiotherapy for head and neck cancer. A prospective longitudinal study

Authors

  • Alexander Ahlberg MD,

    Corresponding author
    1. Department of Otolaryngology and Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
    • Department of Otolaryngology and Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden
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  • Polymnia Nikolaidis RPT,

    1. Department of Physiotherapy, Karolinska University Hospital, Stockholm Sweden
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  • Therese Engström SLP,

    1. Department of Speech Pathology, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Clinical Sciences, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
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  • Karin Gunnarsson RN,

    1. Department of Oncology, Karolinska University Hospital, Stockholm Sweden
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  • Hemming Johansson MS,

    1. Department of Oncology–Statistics, Karolinska University Hospital, Stockholm, Sweden
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  • Lena Sharp PhD, RN,

    1. Department of Oncology, Karolinska University Hospital, Stockholm Sweden
    2. Department of Learning, Informatics, Management and Ethics, Medical Management Center (LIME), Karolinska Institutet, Stockholm, Sweden
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  • Göran Laurell PhD, MD

    1. Department of Clinical Science, Umeå University, Sweden
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  • This study was financed by the Swedish Cancer Society and Laryngfonden.

Abstract

Background

The purpose of this study was to show the investigated impact of supraomohyoidal neck dissection and modified radical neck dissection, both combined with radiotherapy, on cervical range of motion (CROM), mouth opening, swallowing, lymphedema, and shoulder function.

Methods

One hundred eight patients who had neck dissections and 98 patients who had non-neck dissections were evaluated in a prospective, nonselective, longitudinal cohort study by a physiotherapist and a speech-language pathologist (SLP) before the start of radiotherapy and up to 12 months after treatment.

Results

The incidence of shoulder disability after neck dissection was 18%. Supraomohyoidal neck dissection had no significant effect on the evaluated parameters at any time point. Modified radical neck dissection significantly reduced CROM and mouth opening 2 months after treatment, but after 12 months only cervical rotation was still significantly reduced.

Conclusion

In patients treated with external beam radiation (EBRT), modified radical neck dissection induced additional morbidity regarding CROM but not regarding mouth opening, swallowing, and lymphedema 1 year after treatment. Both modified radical neck dissection and supraomohyoidal neck dissection induced shoulder disability. © 2011 Wiley Periodicals, Inc. Head Neck, 2012

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