Complaints of neuropathic pain, noxious cervical plexus neuropathy and neck tightness are reported by patients who undergo neck dissection: an institutional study and narrative review

• Published in: British journal of oral & maxillofacial surgery Vol. 58; no. 9; pp. 1172 - 1179
• Main Authors: Ramphul, A., Hoffman, GR, Islam, S., McGarvey, AC, Powell, AD
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2020
• Subjects: Cervical Plexus; Dentistry; Humans; neck dissection; Neck Dissection - adverse effects; neck tightness; Neuralgia - epidemiology; Neuralgia - etiology; Neuropathic pain; neuropathy; Retrospective Studies; Surveys and Questionnaires; neuropathy; neck dissection; cervical plexus; neck tightness; Neuropathic pain
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2020.08.037

There exists a subgroup of patients who undergo neck dissection (ND) who postoperatively complain of either neuropathic pain, dysaesthesia and/or discomfort that is located within the dermatomal distribution of the cervical plexus. The purpose of our study was to determine the prevalence, characteristic, and demographics of these symptoms in our patient cohort. We undertook a retrospective randomised observational cohort study of 105 patients who had undergone ND. The primary predictor variable was the undertaking of a ND. The secondary outcome variable was the complaint of either neuropathic pain or a noxious neuropathy, at a minimum of twelve months after surgery. A recognised symptom questionnaire and a visual analogue score was employed for the purpose of the study. A descriptive and statistical analysis was applied to the assembled data. Twenty patients (19%) complained of either spontaneous (n=9) or evoked (n=11) neuropathic pain that occurred within the surgical site. In addition, 71 patients (68%) described an altered sensation in the dermatomal distribution of the great auricular or tranverse cervical nerves while 70 patients (67%) described the feeling of ‘neck tightness’. There were no characteristics of the study cohort that underpinned these results. Neuropathic pain can occur following ND. This can cause distress to a small but defined group of patients. Despite its importance, we found a paucity of studies in the literature that have investigated neuropathic pain following ND. We believe this condition requires more research attention and clinical awareness