Gane et al reviewed shoulder and neck dysfunction following neck dissection. The dysfunction may be preceded by a number of risk factors. The authors are from the University of Queensland, Keele University, University of Sydney, Queensland University of Technology, and affiliated hospitals.
Patient selection: status post neck dissection
Dysfunction included:
(1) shoulder and/or neck pain, including myofascial pain
(2) reduced active range of motion for the neck, including rotation
(3) reduced active range of motion for the ipsilateral shoulder, including stiff shoulder
(4) shoulder droop
(5) loss of shoulder strength
Predictors of dysfunction:
(1) type and extent of surgery, especially after radical neck dissection and bilateral dissections
(2) use of nerve sparing technique
(3) damage to the spinal accessory nerve
(4) laryngectomy
Additional factors to consider:
(1) radiation to the neck
(2) psychological distress
(3) disfigurement
