Carr Simon D, Bowyer Duncan, Cox Graham
ENT Department, Leeds General Infirmary, Leeds, United Kingdom.
Head Neck. 2009 Jun;31(6):789-92. doi: 10.1002/hed.21018.
To determine total upper limb function following selective neck dissection over a mean follow-up of 1.6 years.
A retrospective questionnaire study in a tertiary head and neck surgical unit. One hundred forty-eight patients who underwent selective neck dissection for head and neck cancer from January 2000 to December 2005 were invited to participate. The main outcome measure was ipsilateral upper limb dysfunction as measured by the Disability of Arm, Shoulder and Hand (DASH) questionnaire.
Sixty-five patients responded to the invitation to join the study from 148 invited. Despite accessory nerve conserving surgery for all the selective neck dissections studied, 23% reported no upper limb dysfunction, 54% reported mild upper limb dysfunction, 15% reported moderate, and 8% reported a severe dysfunction.
Long-term upper limb dysfunction is common following nerve preserving surgery. The DASH questionnaire is a useful preoperative and postoperative clinical tool for those patients undergoing selective neck dissections.
为确定在平均1.6年的随访期内选择性颈部清扫术后上肢的整体功能。
在一家三级头颈外科单位进行一项回顾性问卷调查研究。邀请了2000年1月至2005年12月期间因头颈癌接受选择性颈部清扫术的148例患者参与。主要结局指标是通过手臂、肩部和手部功能障碍(DASH)问卷测量的同侧上肢功能障碍。
148例受邀患者中有65例回应邀请参与研究。尽管所有研究的选择性颈部清扫术均保留了副神经,但23%的患者报告无上肢功能障碍,54%报告有轻度上肢功能障碍,15%报告有中度功能障碍,8%报告有重度功能障碍。
保留神经的手术后长期上肢功能障碍很常见。DASH问卷对于接受选择性颈部清扫术的患者是一种有用的术前和术后临床工具。