title: Marginal mandibular nerve injury during neck dissection and its impact on patient perception of appearance.
abstract: BACKGROUND
  Neck dissection to remove cervical lymph nodes is common practice in head and neck cancer management. The marginal mandibular nerve may be injured during neck dissection, particularly of level 1. The rate of injury to this nerve is underreported in the literature and its impact on patients is not well defined.
  
  
  METHODS
  An observational study was undertaken on patients who had undergone neck dissection over a 5-year period. The patients were examined for weakness and given a questionnaire related their perception of their appearance and their function.
  
  
  RESULTS
  Sixty-six patients were identified who had undergone 85 neck dissections. The rate of House Brackmann injury was 18% when analyzed by patient and 23% by neck. There were moderate correlations between observed injury and subjective responses to questions relating to ability to smile and weakness of the lower lip.
  
  
  CONCLUSIONS
  The rate of smile asymmetry following neck dissection is relatively high; however, severe injuries to the marginal mandibular nerve are uncommon.
authors.affiliation: Department of Maxillofacial Surgery, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Batstone
authors.forename: Barry
authors.initials: B
authors.lastname: Scott
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.forename: Simon N
authors.initials: SN
authors.lastname: Rogers
mesh_terms: D000368:Aged; D004326:Drinking / Q000502:physiology; D004435:Eating / Q000502:physiology; D004954:Esthetics; D005146:Facial Asymmetry / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008046:Lip / Q000503:physiopathology; D008297:Male; D037981:Neck Dissection / Q000009:adverse effects*; D012737:Sex Factors; D012904:Smiling / Q000502:physiology; D061221:Trigeminal Nerve Injuries