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.