{"title":"文章摘要：作为头颈部肿瘤手术一部分的颈部清扫（保留脊髓副神经）术后功能结局的综合研究。","authors":"Nidhish Rajesh Shah, Girish Mishra, Yojana Sharma","doi":"10.1007/s12070-025-05365-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Head and neck cancers in India comprise nearly 30% of cancer cases, present diagnostic and therapeutic challenges. Neck dissection aims to improve survival outcomes. However, it can lead to complications like shoulder dysfunction, even when the spinal accessory nerve is preserved. Patient-reported outcomes, such as the QuickDASH, are essential in evaluating how these complications affect daily life postoperatively. This study evaluates functional outcomes using QuickDASH, contributing insights to postoperative care.</p><p><strong>Aim: </strong>To measure the functional outcome after Neck Dissection (preserving spinal accessory nerve) in patients undergoing the head & neck oncosurgeries.</p><p><strong>Materials and methods: </strong>In this 14-month observational prospective study, 173 patients who underwent SAN-preserving neck dissections were followed. Postoperative care included physiotherapy, high-protein diet, and standard treatment protocols. Functional outcomes were measured at 6 weeks and 6 months post-surgery using QuickDASH. Statistical analysis included descriptive statistics, T-tests, ANOVA, and Chi-square tests, with a significance level of <i>p</i> < 0.05. Data were analyzed using STATA 14.2.</p><p><strong>Results: </strong>Oral cavity squamous cell carcinoma (OSCC) was the most common diagnosis, representing 85% of cases, with 62% presenting at an advanced stage. The SOHND group exhibited the best functional outcomes at 6 months. Patients with early-stage tumors and those who received postoperative physiotherapy demonstrated improved recovery, while free flaps yielded better shoulder functionality.</p><p><strong>Conclusion: </strong>Despite preserving anatomical integrity, patients often experience upper extremity dysfunction post-surgery, indicating nerve trauma. Immediate postoperative physiotherapy and high protein diet enhances functional recovery, as indicated by improved QuickDASH scores. QuickDASH can be used to identify patients at risk for shoulder dysfunction after neck dissection.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 3","pages":"1492-1498"},"PeriodicalIF":0.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909383/pdf/","citationCount":"0","resultStr":"{\"title\":\"Of the Article: Comprehensive Study on Functional Outcome after Neck Dissection (Preserving Spinal Accessory Nerve) as a Part of Head and Neck Oncosurgeries.\",\"authors\":\"Nidhish Rajesh Shah, Girish Mishra, Yojana Sharma\",\"doi\":\"10.1007/s12070-025-05365-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Head and neck cancers in India comprise nearly 30% of cancer cases, present diagnostic and therapeutic challenges. Neck dissection aims to improve survival outcomes. However, it can lead to complications like shoulder dysfunction, even when the spinal accessory nerve is preserved. Patient-reported outcomes, such as the QuickDASH, are essential in evaluating how these complications affect daily life postoperatively. This study evaluates functional outcomes using QuickDASH, contributing insights to postoperative care.</p><p><strong>Aim: </strong>To measure the functional outcome after Neck Dissection (preserving spinal accessory nerve) in patients undergoing the head & neck oncosurgeries.</p><p><strong>Materials and methods: </strong>In this 14-month observational prospective study, 173 patients who underwent SAN-preserving neck dissections were followed. Postoperative care included physiotherapy, high-protein diet, and standard treatment protocols. Functional outcomes were measured at 6 weeks and 6 months post-surgery using QuickDASH. Statistical analysis included descriptive statistics, T-tests, ANOVA, and Chi-square tests, with a significance level of <i>p</i> < 0.05. Data were analyzed using STATA 14.2.</p><p><strong>Results: </strong>Oral cavity squamous cell carcinoma (OSCC) was the most common diagnosis, representing 85% of cases, with 62% presenting at an advanced stage. The SOHND group exhibited the best functional outcomes at 6 months. Patients with early-stage tumors and those who received postoperative physiotherapy demonstrated improved recovery, while free flaps yielded better shoulder functionality.</p><p><strong>Conclusion: </strong>Despite preserving anatomical integrity, patients often experience upper extremity dysfunction post-surgery, indicating nerve trauma. Immediate postoperative physiotherapy and high protein diet enhances functional recovery, as indicated by improved QuickDASH scores. QuickDASH can be used to identify patients at risk for shoulder dysfunction after neck dissection.</p>\",\"PeriodicalId\":49190,\"journal\":{\"name\":\"Indian Journal of Otolaryngology and Head and Neck Surgery\",\"volume\":\"77 3\",\"pages\":\"1492-1498\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909383/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Otolaryngology and Head and Neck Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12070-025-05365-z\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Otolaryngology and Head and Neck Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12070-025-05365-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/18 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Of the Article: Comprehensive Study on Functional Outcome after Neck Dissection (Preserving Spinal Accessory Nerve) as a Part of Head and Neck Oncosurgeries.
Introduction: Head and neck cancers in India comprise nearly 30% of cancer cases, present diagnostic and therapeutic challenges. Neck dissection aims to improve survival outcomes. However, it can lead to complications like shoulder dysfunction, even when the spinal accessory nerve is preserved. Patient-reported outcomes, such as the QuickDASH, are essential in evaluating how these complications affect daily life postoperatively. This study evaluates functional outcomes using QuickDASH, contributing insights to postoperative care.
Aim: To measure the functional outcome after Neck Dissection (preserving spinal accessory nerve) in patients undergoing the head & neck oncosurgeries.
Materials and methods: In this 14-month observational prospective study, 173 patients who underwent SAN-preserving neck dissections were followed. Postoperative care included physiotherapy, high-protein diet, and standard treatment protocols. Functional outcomes were measured at 6 weeks and 6 months post-surgery using QuickDASH. Statistical analysis included descriptive statistics, T-tests, ANOVA, and Chi-square tests, with a significance level of p < 0.05. Data were analyzed using STATA 14.2.
Results: Oral cavity squamous cell carcinoma (OSCC) was the most common diagnosis, representing 85% of cases, with 62% presenting at an advanced stage. The SOHND group exhibited the best functional outcomes at 6 months. Patients with early-stage tumors and those who received postoperative physiotherapy demonstrated improved recovery, while free flaps yielded better shoulder functionality.
Conclusion: Despite preserving anatomical integrity, patients often experience upper extremity dysfunction post-surgery, indicating nerve trauma. Immediate postoperative physiotherapy and high protein diet enhances functional recovery, as indicated by improved QuickDASH scores. QuickDASH can be used to identify patients at risk for shoulder dysfunction after neck dissection.
期刊介绍：
Indian Journal of Otolaryngology and Head & Neck Surgery was founded as Indian Journal of Otolaryngology in 1949 as a scientific Journal published by the Association of Otolaryngologists of India and was later rechristened as IJOHNS to incorporate the changes and progress.
IJOHNS, undoubtedly one of the oldest Journals in India, is the official publication of the Association of Otolaryngologists of India and is about to publish it is 67th Volume in 2015. The Journal published quarterly accepts articles in general Oto-Rhino-Laryngology and various subspecialities such as Otology, Rhinology, Laryngology and Phonosurgery, Neurotology, Head and Neck Surgery etc.
The Journal acts as a window to showcase and project the clinical and research work done by Otolaryngologists community in India and around the world. It is a continued source of useful clinical information with peer review by eminent Otolaryngologists of repute in their respective fields. The Journal accepts articles pertaining to clinical reports, Clinical studies, Research articles in basic and applied Otolaryngology, short Communications, Clinical records reporting unusual presentations or lesions and new surgical techniques. The journal acts as a catalyst and mirrors the Indian Otolaryngologist’s active interests and pursuits. The Journal also invites articles from senior and experienced authors on interesting topics in Otolaryngology and allied sciences from all over the world.
The print version is distributed free to about 4000 members of Association of Otolaryngologists of India and the e-Journal shortly going to make its appearance on the Springer Board can be accessed by all the members.
Association of Otolaryngologists of India and M/s Springer India group have come together to co-publish IJOHNS from January 2007 and this bondage is going to provide an impetus to the Journal in terms of international presence and global exposure.
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