Objectives: To assess post-operative shoulder morbidity in patients undergoing various types of spinal accessory nerve sparing neck dissection.
Design: All data was collected prospectively. A standardised quality of life questionnaire was used to assess morbidity subjectively. Physical examination of the shoulder, including range of motion with a goniometer and muscle strength using the Oxford scale, was performed to assess morbidity objectively.
Setting: Head and Neck cancer department at Royal Glamorgan Hospital.
Participants: All Head and Neck cancer patients who underwent neck dissection between March 2010 and October 2011.
Main outcome measure: The relationship between the level of neck dissection, with or without adjuvant radiotherapy and degree of post-operative morbidity.
Results: In total 50 neck dissections were performed during this timeframe of which 44 were suitable for the study. All levels of neck dissection were associated with a degree of shoulder morbidity. Clearance of level V nodes was associated with the greatest degree of shoulder stiffness and weakness. Adjuvant radiotherapy did not influence patient outcome.
Conclusions: The study confirms that level V dissection is associated with greatest degree of shoulder morbidity.