Neck treatment and shoulder morbidity: still a challenge.
Shoulder complaints and functional impairment are common sequelae of neck dissection. This is often attributed to injury of the spinal accessory nerve by dissection or direct trauma. Nevertheless, shoulder morbidity may also occur in cases in which the spinal accessory nerve has been preserved. In this article, the physiology and pathophysiology of the shoulder are discussed, followed by a consideration of the impact of neck dissection on shoulder complaints, functional impairment, and quality of life. Finally, rehabilitation will be considered.
Bradley
Patrick J
PJ
Department of Otolaryngology - Head and Neck Surgery, Nottingham University Hospital, Queens Medical Centre, Nottingham, United Kingdom.
Ferlito
Alfio
A
Silver
Carl E
CE
Takes
Robert P
RP
Woolgar
Julia A
JA
Strojan
Primož
P
Suárez
Carlos
C
Coskun
Hakan
H
Zbären
Peter
P
Rinaldo
Alessandra
A
D020436:Accessory Nerve Diseases; D061227:Accessory Nerve Injuries / Q000150:complications*; D002062:Bursitis; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D018482:Muscle, Skeletal / Q000294:innervation; D037981:Neck Dissection / Q000009:adverse effects* / Q000379:methods; D019547:Neck Pain / Q000503:physiopathology; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000503:physiopathology; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012782:Shoulder / Q000502:physiology* / Q000503:physiopathology; D012785:Shoulder Joint / Q000503:physiopathology