Department of Surgical Oncology, Princess Margaret Hospital, Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
Head Neck. 2014 Feb;36(2):299-308. doi: 10.1002/hed.23243. Epub 2013 Apr 1.
The purpose of this article was to provide a review of the literature on shoulder disability after neck dissection.
A literature review was performed using Ovid Medline and Embase databases. A total of 306 abstracts and 78 full-text articles were reviewed. Forty-two articles were eligible for inclusion.
Patients undergoing nerve-sacrifice neck dissections have greater disability and lower quality of life scores than those undergoing neck dissections with the least manipulation (ie, selective neck dissections). Shoulder impairments can still occur in patients undergoing selective neck dissections. Disability typically improves over time in patients undergoing nerve-sparing neck dissections.
There was significant variability in the literature in terms of the prevalence and recovery of shoulder morbidity after neck dissection. This variability may not just be related to surgical technique or rehabilitation, but also to study design, definitions, and the variability in disability questionnaires used.
本文旨在对颈清扫术后肩部残疾的文献进行综述。
通过 Ovid Medline 和 Embase 数据库进行文献回顾。共查阅了 306 篇摘要和 78 篇全文文章,其中 42 篇文章符合纳入标准。
与最少操作(即选择性颈清扫术)的颈清扫术相比,接受神经牺牲颈清扫术的患者残疾和生活质量评分更低。选择性颈清扫术的患者仍可能出现肩部损伤。接受神经保留颈清扫术的患者的残疾程度通常会随时间的推移而改善。
颈清扫术后肩部发病率的发生率和恢复情况在文献中存在显著差异。这种差异可能不仅与手术技术或康复有关,还与研究设计、定义以及使用的残疾问卷的变异性有关。