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Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review

Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review Thumbnail


Abstract

Introduction
Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications.

Methods
Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form – Quantitative Studies.

Results
Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10–100%) compared with MRND (range, 0–100%) and SND (range, 9–25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5–20%). The prevalence of reduced neck active range of motion after neck dissection was 1–13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life.

Conclusions
The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications.

Acceptance Date Oct 31, 2016
Publication Date Nov 17, 2016
Publicly Available Date Mar 29, 2024
Journal European Journal of Surgical Oncology (EJSO)
Print ISSN 0748-7983
Publisher Elsevier
Pages 1199-1218
DOI https://doi.org/10.1016/j.ejso.2016.10.026
Keywords neck dissection, head and neck neoplasms, shoulder pain, neck pain, quality of life, risk factors
Publisher URL http://dx.doi.org/10.1016/j.ejso.2016.10.026

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