van Wilgen C P, Dijkstra P U, van der Laan B F A M, Plukker J Th M, Roodenburg J L N
Department of Oral and Maxillofacial Surgery, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Int J Oral Maxillofac Surg. 2004 Apr;33(3):253-7. doi: 10.1006/ijom.2003.0507.
The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least 1 year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the shoulder disability questionnaire to evaluate shoulder disability in daily activities. In total 137 patients; 51 after modified radical neck dissection (MRND), 21 after postero-lateral neck dissection (PLND), and 65 after supraomohyoid neck dissection (SOHND) were analysed. After MRND 33.3% of the patients experienced shoulder complaints, after PLND 66.7%, and after SOHND 20% of the patients experienced shoulder complaints. Type of neck dissection was significantly (P < 0.001) related to shoulder complaints. Outcome on the shoulder disability questionnaire also showed a significant (P < 0.01) difference in outcome for type of neck dissection. The prevalence of shoulder complaints after SOHND are low, and reduce disability in daily activities. Radiation therapy does not have a significant effect on shoulder complaints and disability.
本研究的目的是分析保留神经的颈部清扫术后至少1年肩部不适的发生率,并分析放射治疗对肩部不适的影响。对患者进行肩部不适方面的访谈,并让患者填写肩部残疾问卷以评估日常活动中的肩部残疾情况。总共分析了137例患者,其中51例接受改良根治性颈部清扫术(MRND),21例接受后外侧颈部清扫术(PLND),65例接受肩胛舌骨上颈部清扫术(SOHND)。MRND术后33.3%的患者出现肩部不适,PLND术后为66.7%,SOHND术后为20%。颈部清扫术的类型与肩部不适显著相关(P < 0.001)。肩部残疾问卷的结果也显示,颈部清扫术类型的结果存在显著差异(P < 0.01)。SOHND术后肩部不适的发生率较低,且日常活动中的残疾程度降低。放射治疗对肩部不适和残疾没有显著影响。