Pain in the neck after neck dissection.
BACKGROUND
Reports of disability after neck dissection have been directed toward shoulder dysfunction and pain. We could find no report addressing the issue of pain localized to the actual operative site. We have conducted a combined prospective and retrospective study of pain in patients undergoing neck dissection.


METHODS
Eighty-eight disease-free patients were evaluated in 3 groups for neck pain. One group was followed up prospectively for 1 to 8 months after surgery, and 2 retrospective groups were followed up for more than 2 years or for 6 months to 2 years. Pain was assessed by a body map and visual analog scale.


RESULTS
None of 31 patients followed up for more than 2 years reported neck pain. Four of 27 patients followed up for 6 to 24 months had pain, with a mean visual analog scale score of 3.7. Seventy percent of the prospective group of 30 patients had pain during the first postoperative week, and only 1 patient had pain persisting for more than 2 months. Shoulder pain and disability after radical neck dissection were encountered in all groups, comparable with the incidence reported in the literature. No postoperative neuromas were found.


CONCLUSIONS
Chronic pain localized to the operative site is an uncommon occurrence even after radical neck dissection. Chronic pain in the shoulder region may follow radical neck dissection, whereas modified neck dissection is usually a painless procedure.
Talmi
Y P
YP
Department of Otolaryngology-Head and Neck Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Horowitz
Z
Z
Pfeffer
M R
MR
Stolik-Dollberg
O C
OC
Shoshani
Y
Y
Peleg
M
M
Kronenberg
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D011446:Prospective Studies; D012189:Retrospective Studies