The Sonography and Physical Findings on Shoulder after Selective Neck Dissection in Patients with Head and Neck Cancer: A Pilot Study

Yu-Chi Huang, Yan-Yuh Lee, Hui-Hsin Tso, Po-Cheng Chen, Yi-Cun Chen, Chih-Yen Chien, Ya-Ju Chung, Chau-Peng Leong, Yu-Chi Huang, Yan-Yuh Lee, Hui-Hsin Tso, Po-Cheng Chen, Yi-Cun Chen, Chih-Yen Chien, Ya-Ju Chung, Chau-Peng Leong

Abstract

The aim of this study is to investigate soft tissue disorders of affected shoulders after nerve-sparing selective neck dissection (SND) in patients with head and neck cancers (HNCs) by sonography. Eighteen HNCs patients with shoulder disability after SND were enrolled. Shoulder motions, pain, and the sonographic findings were measured and analyzed. Significantly decreased flexion, abduction, and increased pain were found on affected shoulders compared with normal shoulders. There were significant decrease in thickness of trapezius muscle (p=0.001), abnormal findings of supraspinatus tendon (p=0.022), and subdeltoid bursa (p=0.018) on surgical side. The ratio of trapezius muscle atrophy was related to shoulder pain (p=0.010). Patients with subdeltoid abnormalities had significant limitation on shoulder flexion and abduction. Abnormalities of supraspinatus tendon and subdeltoid bursa on sonography and trapezius muscle atrophy may play a key role in shoulder pain and shoulder flexion and abduction limitations.

Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The correlation between the ratio of trapezius atrophy and the level of pain. Spearman correlation was used to analyze the relation between level of trapezius atrophy and pain. The X axis was the level of shoulder pain, which was assessed with VAS; the Y axis represented the ratio of trapezius atrophy that was calculated with the sonography results.
Figure 2
Figure 2
The between-group comparisons of shoulder movements based on sonographic findings of subdeltoid bursa (a) or supraspinatus tendon (b).

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