Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Biomed Res Int. 2019 Jul 22;2019:2528492. doi: 10.1155/2019/2528492. eCollection 2019.
The aim of this study is to investigate soft tissue disorders of affected shoulders after nerve-sparing selective neck dissection (SND) in patients with head and neck cancers (HNCs) by sonography. Eighteen HNCs patients with shoulder disability after SND were enrolled. Shoulder motions, pain, and the sonographic findings were measured and analyzed. Significantly decreased flexion, abduction, and increased pain were found on affected shoulders compared with normal shoulders. There were significant decrease in thickness of trapezius muscle (p=0.001), abnormal findings of supraspinatus tendon (p=0.022), and subdeltoid bursa (p=0.018) on surgical side. The ratio of trapezius muscle atrophy was related to shoulder pain (p=0.010). Patients with subdeltoid abnormalities had significant limitation on shoulder flexion and abduction. Abnormalities of supraspinatus tendon and subdeltoid bursa on sonography and trapezius muscle atrophy may play a key role in shoulder pain and shoulder flexion and abduction limitations.
本研究旨在通过超声检查研究头颈部癌症（HNC）患者神经保留选择性颈清扫术（SND）后受影响肩部的软组织障碍。共纳入 18 例 SND 后肩部功能障碍的 HNC 患者。测量并分析了肩部运动、疼痛和超声检查结果。与健侧相比，患侧肩关节的前屈、外展明显减少，疼痛明显增加。斜方肌厚度明显变薄（p=0.001），冈上肌腱（p=0.022）和三角肌下滑囊（p=0.018）异常发现于手术侧。斜方肌萎缩的比例与肩部疼痛相关（p=0.010）。肩峰下间隙异常的患者，肩关节前屈和外展活动受限明显。超声检查显示冈上肌腱和三角肌下滑囊异常以及斜方肌萎缩可能是导致肩部疼痛以及肩关节前屈和外展受限的关键因素。
