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Hiroyuki Inoue, MD; Ken-ichi Nibu, MD, PhD; Miki Saito, MD; Naoki Otsuki, MD; Haruhiko Ishida, MD; Tetsuro Onitsuka, MD; Takashi Fujii, MD; Kazuyoshi Kawabata, MD; Masahisa Saikawa, MD

Arch Otolaryngol Head Neck Surg. 2006;132:662-666.

Objective  To assess the impact of modifications to radical neck dissection on postoperative quality of life.

Design  Cross-sectional study using a self-administered neck dissection questionnaire and an arm abduction test.

Setting  Department of Otolaryngology–Head and Neck Surgery, Kobe University Hospital.

Patients  Seventy-four patients who had undergone neck dissection for the treatment of head and neck cancer.

Main Outcome Measures  Arm abduction test results and responses to questions on quality of life related to neck dissection.

Results  Forty-one patients underwent bilateral neck dissections, and 33 patients underwent unilateral neck dissection. Level V nodes were dissected in 74 necks. Among them, the spinal accessory nerve (SAN) was resected in 29 necks. Patients who had neck dissections that spared the SAN had better shoulder function. When the SAN was preserved, patients without dissection of level IV and V nodes had better scores on measures of pain and constriction of the neck. Sacrifice of the sternocleidomastoid muscle and/or the SAN had a significant effect on daily activities, work, and leisure. The arm abduction test scores and answers to questions regarding shoulder function were significantly correlated.

Conclusions  Modifications to radical neck dissection contribute to improvements in the postoperative quality of life after neck dissection. A multicenter study using the arm abduction test and questionnaire used in this study is currently in progress to further evaluate the impact of modifications to radical neck dissection on quality of life after surgery.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Kobe University Hospital, Kobe, Japan (Drs Inoue, Nibu, Saito, Otsuki, and Ishida); Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan (Dr Onitsuka); Department of Otolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan (Dr Fujii); Department of Head and Neck, Cancer Institute Hospital, Tokyo, Japan (Dr Kawabata); and Department of Head and Neck, National Cancer Center Hospital East, Chiba, Japan (Dr Saikawa).