02596nas a2200337   4500000000100000008004100001653001100042653001400053653001500067653002000082653003200102653003100134653001900165653001800184653002800202653000900230653002000239653002800259100001100287700001600298700001500314700001400329700001300343700001400356700001400370245012200384300001400506490000700520520171700527022001402244       2017                            d10aHumans10aIncidence10aPrevalence10aQuality of Life10aPostoperative Complications10aRange of Motion, Articular10aShoulder Joint10aShoulder Pain10aHead and Neck Neoplasms10aNeck10aNeck Dissection10aSomatosensory Disorders1 aGane E1 aMichaleff Z1 aCottrell M1 aMcPhail S1 aHatton A1 aPanizza B1 aO'Leary S00aPrevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review.  a1199-12180 v433 a<p>
<b>INTRODUCTION: </b>Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications.
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<b>METHODS: </b>Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies.
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<b>RESULTS: </b>Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life.
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<b>CONCLUSIONS: </b>The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications.
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