Abstract

Case Series

Shoulder recovery for head and neck cancer patients after unilateral neck dissection: a pilot exploratory study

Celia Ia Choo Tan*, Pauline Hui Ling Yeo, Mahalakshmi Rangabashyam, Aisyah Binte Omar, Cindy Li Whye Ng, Rehena Sultana, Kevin Netto, Meng Ai Png, Rahul Nagadia, Gerald Ci An Tay, Ngian Chye Tan, N Gopalakrishna Iyer and Hiang Khoon Tan

Published: 28 September, 2022 | Volume 6 - Issue 2 | Pages: 011-017

An established side-effect of neck dissection (ND) for head and neck (HNC) tumour management includes shoulder dysfunction (SD), which can impact quality of life (QOL). Shoulder strength and range of movement (ROM) are key parameters to be monitored in SD. However, such evaluations are not routinely conducted in the clinical setting. The aim of this study was to evaluate objectively the impact of ND on shoulder functions. 
Methods: This is a pilot exploratory study in a tertiary cancer centre. Five participants with unilateral ND and advanced HNC, completed the study. Outcome measures consisted of self-reported QOL questionnaires, C2–T1 dermatomes and shoulder ROM and strength testing. Data was collected at baseline, 1.5-months after surgery and 6-months after diagnosis (after adjuvant treatment completion). 
Results: Most outcome measures on the surgically affected side were negatively impacted post-operatively, with varied recovery seen at follow-up. Sensory loss was noted at C3–4 dermatome levels. Shoulder ROM and strength was reduced on the surficial side for all participants, with some recovery after six months except for two participants.
Conclusion: Results of SD after ND are diverse and unique to each patient. Findings from this pilot study indicate that regular rehabilitation/exercise may facilitate recovery of shoulder function post HNC surgery. However, customised rehabilitation may yield better outcomes. Future studies with a larger sample are indicated to validate the findings of this study.

Read Full Article HTML DOI: 10.29328/journal.jnpr.1001045 Cite this Article Read Full Article PDF

Keywords:

Head and neck cancer; Neck dissection; Shoulder disability; Physical therapy; Rehabilitation QOL

References

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