Neck Dissection Shoulder Syndrome: Quantification and Three-Dimensional Evaluation with an Optoelectronic Tracking System

• Published in: Annals of otology, rhinology & laryngology Vol. 112; no. 11; pp. 939 - 946
• Main Authors: Caversaccio, Marco, Nolte, Lutz-Peter, Negri, Sandro, Zbären, Peter
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2003; Annals Publishing Compagny; SAGE PUBLICATIONS, INC
• Subjects: Accessory Nerve - physiology; Biological and medical sciences; Biomechanical Phenomena; Carcinoma, Squamous Cell - surgery; Case-Control Studies; Combined surgery. Multiple transplantations; Digestive System Neoplasms - surgery; Electronics, Medical; Humans; Male; Medical sciences; Middle Aged; Neck Dissection - adverse effects; Optics and Photonics - instrumentation; Respiratory Tract Neoplasms - surgery; Scapula - physiopathology; Shoulder - physiopathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Syndrome; optoelectronic tracking device; neck dissection; shoulder; three-dimensional kinematics; Human; Optoelectronics; Surgery; Shoulder; Exploration; Tridimensional image; Neck; Dissection
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/000348940311201105

Objective 3-dimensional biomechanical changes of the shoulder at rest or during arm elevation were measured by means of a new specific method using an optoelectronic detection system that was developed for computer-aided surgery. Additionally, the shoulder syndrome following neck dissection was evaluated by the recognized orthopedic shoulder Constant score. The statistical evaluation encompassed 12 patients with unilateral radical neck dissection (RND), 12 patients with unilateral modified radical neck dissection (MRND) with preservation of the accessory nerve, and 10 healthy subjects. The healthy shoulders showed normal kinematic behavior, the so-called “scapulohumeral rhythm” (SHR). After MRND, the static scapular position and SHR showed no significant 3-dimensional variations. In contrast, RND produced a highly significant scapular displacement at rest (p < .01) and a near-total abolition of SHR. The Constant scores were significantly lower after RND than after MRND (p < .01). Three-dimensional evaluation of the shoulder syndrome supports the Constant score, quantifying what can be measured objectively.