A prospective study of shoulder disability resulting from radical and modified neck dissections.

A prospective longitudinal study of shoulder function after 103 neck dissections involving either preservation or sacrifice of the spinal accessory nerve is presented. The postoperative evolution and course of trapezius muscle denervation and resultant shoulder dysfunction were objectively determined for both radical and modified nerve sparing neck dissections. All patients were enrolled in a program of physical therapy aimed at maintaining range of motion at the shoulder joint. Shoulder function was examined preoperatively and for 12 months postoperatively with manual muscle strength testing, range of motion measurements, and electrodiagnostic testing. Results indicate that modified nerve sparing dissections are followed on the average by a significant, but temporary and reversible phase of shoulder dysfunction. By comparison, radical neck dissection is followed by profound and permanent trapezius muscle weakness and denervation.

[1]  G. Laramore,et al.  Shoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve. , 1984, American journal of surgery.

[2]  J. Suen,et al.  Functional evaluation of the spinal accessory nerve after neck dissection. , 1983, American journal of surgery.

[3]  J. H. Brandenburg,et al.  The eleventh nerve in radical neck surgery , 1981, The Laryngoscope.

[4]  C. Carenfelt,et al.  Occurrence, duration and prognosis of unexpected accessory nerve paresis in radical neck dissection. , 1980, Acta oto-laryngologica.

[5]  James H. Hill,et al.  The surgical anatomy of the spinal accessory nerve and the internal branch of the superior laryngeal nerve , 1979, The Laryngoscope.

[6]  G. Becker,et al.  Technique of preserving the spinal accessory nerve during radical neck dissection , 1979, The Laryngoscope.

[7]  D. Larson,et al.  Radical or modified neck dissection: a therapeutic dilemma. , 1978, American journal of surgery.

[8]  J. T. Black,et al.  Acessory nerve function after surgical procedures in the posterior triangle. , 1977, Archives of surgery.

[9]  E. Bocca.  Conservative neck dissection , 1975, The Laryngoscope.

[10]  R. Flowers,et al.  Free grafts of the spinal accessory nerve during radical neck dissection. , 1969, American journal of surgery.

[11]  O. Beahrs,et al.  Spinal accessory nerve in radical neck dissections. , 1969, American journal of surgery.

[12]  E. Skolnik,et al.  Preservation of XI cranial nerve in neck dissections , 1967, The Laryngoscope.

[13]  A. Ballantyne,et al.  Reduction of shoulder disability after neck dissection. , 1966, American journal of surgery.

[14]  W. Mullally,et al.  A syndrome resulting from radical neck dissection. , 1961, Archives of otolaryngology.

[15]  H. Martin,et al.  Disability following “radical neck dissection”. An assessment based on the postoperative evaluation of 100 patients , 1952, Cancer.

[16]  S. Mead.  Posterior triangle operations and trapezius paralysis. , 1952, Archives of Surgery.

[17]  Arieff Aj.  Newer concepts of electrodiagnosis in peripheral nerve injuries. , 1948 .

[18]  K. B. Corbin,et al.  THE SENSORY INNERVATION OF THE SPINAL ACCESSORY AND TONGUE MUSCULATURE IN THE RHESUS MONKEY , 1939 .