title: Neck Dissection's Burden on the Patient: Functional and Psychosocial Aspects in 1,652 Patients With Oral Squamous Cell Carcinomas.
abstract: OBJECTIVE
  In this study of patients with oral squamous cell carcinoma, the authors sought to clarify the functional and psychosocial harms of neck dissection (ND), which lessens quality of life.
  
  
  METHODS
  The study included questionnaire responses from patients with oral squamous cell carcinoma (n = 1,652) and clinicians (n = 1,489), as collected in the DÖSAK Rehab Study. Psychosocial and functional factors were assessed. Functional and psychosocial outcomes in patients who did not receive ND were compared with those in patients who underwent selective supraomohyoid ND (SND), modified radical ND (MND), and radical ND (RND).
  
  
  RESULTS
  Patients with ND had lower quality of life than those without ND. Burdens after SND (n = 923) were generally lesser than those after MND (n = 301) or RDN (n = 678). There were meaningful differences between the SND, MND, and RND and without-ND groups in impairments in speech intelligibility for strangers and familiar persons, ingestion and swallowing, tongue mobility, opening of the mouth, lower jaw mobility, neck mobility, and shoulder and arm movement (P < .05). Many patients with ND faced a lower functional status and negative professional and financial consequences.
  
  
  CONCLUSIONS
  Because of the burdens associated with ND, the decision to perform this treatment for oral squamous cell carcinoma should incorporate information on health-related quality of life and survival rates.
authors: Consultant, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany. Electronic address: spalthoff.simon@mh-hannover.de.
authors: Simon
authors: S
authors: Spalthoff
authors: Resident, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
authors: Rüdiger
authors: R
authors: Zimmerer
authors: Consultant, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
authors: Philipp
authors: P
authors: Jehn
authors: Professor, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
authors: Nils-Claudius
authors: NC
authors: Gellrich
authors: Professor, Department of Cranio and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors: Jörg
authors: J
authors: Handschel
authors: Medical Psychologist and Professor, Department of Medical Psychology, Ruhr University of Bochum, Bochum, Germany.
authors: Gertrud
authors: G
authors: Krüskemper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection; D011183:Postoperative Complications; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome