Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Head Neck. 2013 Sep;35(9):1303-13. doi: 10.1002/hed.23131. Epub 2012 Sep 13.
Neck and shoulder complaints can be a direct result of a neck dissection.
Maximal active lateral flexion of the neck, forward flexion and abduction of the shoulder, and self-perceived function were determined in 145 patients treated for oral cancer.
No short-term influence of radiotherapy was found on measured range of motion and self-perceived neck and shoulder function (p > .05). One year after a bilateral neck dissection, patients showed deteriorated lateral flexion of the neck, whereas patients treated with a unilateral modified radical neck dissection still reported pain during neck movements. Maximal forward flexion of the shoulder recovered to the level of healthy controls, but maximal abduction was still reduced in all patients.
Neck dissection, tumor site, and extensive reconstruction are related to deterioration of shoulder function shortly after intervention. Maximal active shoulder abduction was affected most.
颈部和肩部的不适可能是颈部清扫术的直接结果。
对 145 例接受口腔癌治疗的患者进行了最大主动颈部侧屈、肩部前屈和外展以及自我感知功能的测定。
放射治疗对测量的活动范围和自我感知的颈部和肩部功能没有短期影响(p>.05)。在双侧颈清扫术后 1 年,患者的颈部侧屈明显恶化,而接受单侧改良根治性颈清扫术的患者在颈部活动时仍有疼痛。肩部的最大前屈恢复到健康对照组的水平,但所有患者的最大外展仍受限。
颈清扫术、肿瘤部位和广泛重建与术后短期的肩部功能恶化有关。最大主动肩外展受影响最大。