[Origin of shoulder pain after "neck dissection". Importance of the cervical plexus].
BACKGROUND
The role of sensitive parts of the cervical plexus for the development of neuropathic pain is not yet clear. Our study investigated the correlation between shoulder pain and cervical plexus damage after different types of neck dissection (ND).


METHODS
The sensitivity for warm/cold and sharp/blunt was tested in the dermatomes of C2, C3, C4, and the minor occipital nerve. Shoulder pain was measured semiquantitatively by a rating scale.


RESULTS
Motion-dependent shoulder pain was observed 6 months postoperatively in 50% after resection and in 29.2% after preservation of these structures. Pain occurred more frequently following radical ND than after modified radical types 1 and 3 ND.


CONCLUSIONS
Our investigations showed that the superficial cervical plexus function is assessable by cutaneous sensitivity tests. The minor occipital nerve seemed to be less affected. Fewer pain symptoms in cases with preserved cervical plexus could be demonstrated. We can conclude that preservation of the superficial cervical plexus is important to diminish postoperative shoulder pain.
Agha-Mir-Salim
Parwis
P
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Strasse 12, 06097 Halle. p.mir-salim@medizin.uni-halle.de
Schulte-Mattler
W
W
Funk
U
U
Lautenschläger
C
C
Bloching
M
M
Berghaus
A
A
D002572:Cervical Plexus / Q000293:injuries* / Q000503:physiopathology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D010039:Otorhinolaryngologic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D010149:Postoperative Pain / Q000209:etiology* / Q000503:physiopathology; D011843:Radiculopathy / Q000503:physiopathology*; D018714:Radiotherapy, Adjuvant; D011984:Sensory Receptor Cells / Q000503:physiopathology; D012684:Sensory Thresholds / Q000502:physiology; D020069:Shoulder Pain / Q000209:etiology* / Q000503:physiopathology