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Effects of combined modality therapy of head and neck carcinoma on shoulder and head mobility
Author(s) -
Nowak Peggyann,
Parzuchowski Jeanne,
Jacobs John R.
Publication year - 1989
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930410303
Subject(s) - medicine , head and neck , modality (human–computer interaction) , head (geology) , treatment modality , head and neck cancer , radiology , carcinoma , radiation therapy , oncology , surgery , human–computer interaction , geomorphology , computer science , geology
One hundred twenty‐six patients were evaluated prospectively for head and shoulder mobility following combined treatment of their advanced head and neck carcinoma. In the absence of a pectoral myocutaneous flap reconstruction, the sacrifice of the spinal accessory nerve does not appear to be deleterious to overall head and shoulder mobility with the exception of shoulder elevation. The addition of the pectoral myocutaneous flap reconstruction negated the shoulder elevation difference between the modified neck dissection and the classical neck dissection. The administration of postoperative radiation therapy appears to decrease the range of motion of both the head and the shoulder by up to 20%. We conclude that head and shoulder mobility following combined modality treatment for patients with head and neck carcinoma appears to be a multifaceted problem involving more than the presence or absence of the accesory nerve and psychosocial considerations. The multifaceted etiology of this problem should be taken into consideration when developing physical and occupational programs directed specifically at this problem.