Objective comparison of shoulder dysfunction after three neck dissection techniques

A prospective study with subjective evaluation of shoulder pain and objecti ve evaluation of shoulder muscle strength by isokinetic testing and electro myographic and electroneurographic studies of spinal accessory nerve functi on was performed on patients who had undergone neck dissection procedures. Twenty-one patients with head and neck cancer were enrolled in this study. Three types of neck dissection were performed: 7 selective neck dissections , 9 modified radical neck dissections, and 5 radical neck dissections. All patients who underwent radical neck dissection had shoulder pain, and 80% o f them had shoulder droop after the operation. In the patients who underwen t selective neck dissection, the electromyographic findings of the spinal a ccessory nerve were relatively normal. Their shoulder strength was sometime s decreased at I month after operation, but it had returned to preoperative strength by the 6-month follow-up visit. These findings suggested that pat ients who underwent selective neck dissection had the least damage to spina l accessory nerve function and the least shoulder disability after neck dis section.