Cervical sensory preservation during neck dissection

• Published in: Oral oncology Vol. 43; no. 5; pp. 491 - 498
• Main Authors: Roh, Jong-Lyel, Yoon, Yeo-Hoon, Kim, Sang Yoon, Park, Chan Il
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2007; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; Cervical root branches; Cervical Vertebrae; Depression; Depression - etiology; Female; Hematology, Oncology and Palliative Medicine; Humans; Male; Medical sciences; Middle Aged; Mood disorders; Neck dissection; Neck Dissection - adverse effects; Neck Dissection - methods; Neck Dissection - psychology; Otolaryngology; Otorhinolaryngologic Neoplasms - surgery; Otorhinolaryngology. Stomatology; Pain; Pain - etiology; Preservation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Retrospective Studies; Sensory loss; Spinal Nerve Roots - surgery; Tumors; Pain; Preservation; Depression; Cervical root branches; Sensory loss; Neck dissection; Quality of life; Mood disorder; Human; Depressions; Stomatology; Conservation; ENT; Cervical root; Cancerology; Treatment; Surgery; Sensory disorder; Neck; Dissection
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2006.05.003

Summary Although the practice of neck dissection has greatly advanced from radical to function-preserving surgery, the impact of the sensory nerve-preserving neck surgery on the pain and quality of life (QOL) of patients has received little study. We evaluated neck morbidity and its impact on QOL associated with selective or modified radical neck dissection with or without preservation of cervical root branches. We conducted a retrospective cohort study comparing 24 patients who had their cervical root branches preserved to 29 patients whose root branches were removed during neck dissection. The spinal accessory nerve was preserved and sex, age, pathologic status, side and extent of neck dissection, and radiotherapy were comparable between groups. The groups were compared based on sensory and motor functions of the neck and shoulder and questionnaires on depression and QOL at follow-up of mean 18.7 (range 12–34) months after surgery. The nerve-preserved patients showed a low incidence and severity of neck and shoulder pain compared to the nerve-removed subjects ( p < .05). Loss of sensation was more frequently experienced in the nerve-removed group on the earlobe and the lateral neck of the operated side ( p < .05). Depression and QOL scores were higher in the nerve-removed group and significantly correlated with pain intensity. Preservation of the cervical root branches reduces postoperative pain as well as permanent anesthetic areas of the neck. This may also improve the mental state and QOL of patients undergoing neck dissection.