International Journal of Clinical Oncology and Cancer Research

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An Analysis of Complications of Neck Dissection in Head and Neck Cancers

Received: Apr. 12, 2020    Accepted: May 03, 2020    Published: May 19, 2020
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Abstract

The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.

DOI 10.11648/j.ijcocr.20200502.12
Published in International Journal of Clinical Oncology and Cancer Research ( Volume 5, Issue 2, June 2020 )
Page(s) 24-28
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neck Dissection Complications, Head and Neck Cancers, Marginal Mandibular Nerve Injury, Spinal Accessory Nerve Injury, IJV Injury

References
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[21] Short SO, Kaplan JN, Laramore GE CC. Shoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve. Am J Surg. 1984; 148: 478–82.
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  • APA Style

    Shashidhar Kallappa, Prajwal Dange. (2020). An Analysis of Complications of Neck Dissection in Head and Neck Cancers. International Journal of Clinical Oncology and Cancer Research, 5(2), 24-28. https://doi.org/10.11648/j.ijcocr.20200502.12

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    ACS Style

    Shashidhar Kallappa; Prajwal Dange. An Analysis of Complications of Neck Dissection in Head and Neck Cancers. Int. J. Clin. Oncol. Cancer Res. 2020, 5(2), 24-28. doi: 10.11648/j.ijcocr.20200502.12

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    AMA Style

    Shashidhar Kallappa, Prajwal Dange. An Analysis of Complications of Neck Dissection in Head and Neck Cancers. Int J Clin Oncol Cancer Res. 2020;5(2):24-28. doi: 10.11648/j.ijcocr.20200502.12

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  • @article{10.11648/j.ijcocr.20200502.12,
      author = {Shashidhar Kallappa and Prajwal Dange},
      title = {An Analysis of Complications of Neck Dissection in Head and Neck Cancers},
      journal = {International Journal of Clinical Oncology and Cancer Research},
      volume = {5},
      number = {2},
      pages = {24-28},
      doi = {10.11648/j.ijcocr.20200502.12},
      url = {https://doi.org/10.11648/j.ijcocr.20200502.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcocr.20200502.12},
      abstract = {The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.},
     year = {2020}
    }
    

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    AB  - The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.
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Author Information
  • Department of Surgical Oncology, Karnataka Institute of Medical Sciences, Hubli, India

  • Department of Otorhinolaryngology, Karnataka Institute of Medical Sciences, Hubli, India

  • Section