Shoulder function after neck dissection with level IIb preservation: a prospective observational study

Acta Otolaryngol. 2023 Sep;143(9):814-822. doi: 10.1080/00016489.2023.2261985. Epub 2023 Nov 8.

Abstract

Background: Shoulder syndrome can be reduced by preserving the spinal accessory nerve (SAN). However, it is unclear whether performing level IIb preservation will decrease the risk of SAN injury and shoulder syndrome.

Aims/objectives: We investigated whether neck dissection with level IIb preservation can reduce shoulder dysfunction and postoperative quality of life (QOL) in head and neck cancer patients.

Material and methods: This prospective observational study enrolled patients who underwent neck dissection from 2011 to 2014. Patients were divided into three groups (level IIb preservation group [group 1], IIb dissection group [group 2], and IIb and V dissection group [group 3]). Postoperative shoulder function and QOL were evaluated among the three groups.

Results: There were a total of 35 neck sides in three groups, with nine neck sides in group 1, 16 neck sides in group 2, and 10 neck sides in group 3. Although the results showed less shoulder dysfunction in group 1 at early postoperative period. The QOL in group 1 was preserved in the early postoperative period.

Conclusions and significance: Neck dissection with level IIb preservation may help reduce shoulder syndrome and maintain QOL in the early postoperative period.

Keywords: QOL; Shoulder syndrome; level IIb; neck dissection; spinal accessory nerve.

Publication types

  • Observational Study

MeSH terms

  • Accessory Nerve / surgery
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Neck Dissection / adverse effects
  • Neck Dissection / methods
  • Quality of Life
  • Shoulder* / innervation
  • Shoulder* / surgery