title: Shoulder morbidity after pectoralis major flap reconstruction for head and neck cancer.
abstract: BACKGROUND
  The effect of pectoralis major flap (PMF) harvest on shoulder function, allowing for the effects of neck dissection, has not previously been objectively measured.
  
  
  METHODS
  Twenty-two patients who underwent PMF reconstruction were studied. The control group comprised 35 patients with neck dissection (without PMF). Neck dissections in both groups were classified into 3 grades; grade 1: no neck dissection/selective neck dissection; grade 2: modified radical neck dissection; grade 3: radical neck dissection/extended radical neck dissection. Objective shoulder assessments were carried out using Constant score.
  
  
  RESULTS
  Constant score deteriorated with grade of neck dissection (p < .005). The median Constant score for PMF group and neck dissection only group were 82 and 90, respectively (p = .40). Subgroup analysis within neck dissection grade did not show any significant difference, but the effect of PMF was noted to be greatest in grade 2 patients (p = .064).
  
  
  CONCLUSIONS
  There is minimal or low shoulder morbidity, additional to neck dissection, caused by PMF reconstruction in head and neck surgery.
authors.affiliation: Department of Surgery, Christie Hospital, Manchester, United Kingdom.
authors.forename: Ashirwad
authors.initials: A
authors.lastname: Merve
authors.forename: Indu
authors.initials: I
authors.lastname: Mitra
authors.forename: Ric
authors.initials: R
authors.lastname: Swindell
authors.forename: Jarrod J
authors.initials: JJ
authors.lastname: Homer
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D037981:Neck Dissection; D010369:Pectoralis Muscles / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D020069:Shoulder Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013524:Surgical Flaps / Q000009:adverse effects*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*