Is Superselective Neck Dissection Safer Than Supraomohyoid Neck Dissection for Oral Carcinoma Patients With N0 Neck in Terms of Shoulder Morbidity and Recurrence Rate?

Abstract

Purpose: To estimate the clinical and functional results of patients who underwent distinctive types of neck dissection, with particular emphasis on shoulder function, rate of recurrence, and quality of life in patients with N0 neck.

Materials and methods: A randomized clinical trial was conducted from August 2014 to March 2017 in which 20 adult patients with T1 to T3 lesions of the oral cavity and N0 neck were included. Patients were randomly allocated to group I (n = 10; selective neck dissection) or group II (n = 10; superselective neck dissection). All patients were evaluated objectively for degree of arm abduction and subjectively for quality of life using a questionnaire completed pre- and postoperatively at 6 months. Also, locoregional recurrence was investigated for 2.5 years. Data were scrutinized by applying mean and standard deviation, unpaired t test, Mann-Whitney U test, and Kaplan-Meier test.

Results: Mean values of the Arm Abduction Test and quality-of-life scores were statistically significant (P < .05) for group II compared with group I at all intervals. Data analyzed for locoregional recurrence showed a statistically significant difference between groups (P < .05), with group II having the better outcome.

Conclusion: The results showed less shoulder morbidity and improved quality of life for superselective neck dissection (group II) compared with selective neck dissection (group I). Furthermore, group II was better for locoregional recurrence, which determines the oncologic safety of the procedure.