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. 2019 Jul;27(7):2553-2560.
doi: 10.1007/s00520-018-4534-1. Epub 2018 Nov 14.

Factors influencing neck and shoulder function after oral oncology treatment: a five-year prospective cohort study in 113 patients

Gerben van Hinte  1 , Jan-Willem G H Wetzels  2   3 , Matthias A W Merkx  2 , Anton F J de Haan  4 , Ron Koole  3 , Caroline M Speksnijder  5   6   7   8
Affiliations

Factors influencing neck and shoulder function after oral oncology treatment: a five-year prospective cohort study in 113 patients

Gerben van Hinte et al. Support Care Cancer. 2019 Jul.

Abstract

Background: The aim of this study was to identify factors influencing shoulder and/or neck function in patients up to five years after treatment.

Materials and methods: Lateral flexion of the neck, ipsilateral forward flexion, and abduction of the shoulder were measured. Potential factors were entered into a linear mixed model analysis to create a multivariate model for describing the results.

Results: Predicted neck and shoulder function was negatively influenced by higher age before intervention. Contralateral flexion of the neck was lower for patients undergoing surgery and radiotherapy compared to surgery. Ipsilateral flexion of the neck is influenced by a higher age at baseline. Ipsilateral shoulder abduction is lower for female gender, bone graft/flap reconstruction, and more extensive neck dissection. Ipsilateral forward flexion of the shoulder is lower for bone graft/flap reconstruction and better for patients with a T2 tumor in comparison to T3 and T4 tumors, as predicted.

Conclusion: By our five-year follow-up outcomes of this study, neck and/or shoulder impairments can be found for high-risk patients by physiotherapists.

Keywords: Mixed models; Mouth neoplasms; Neck dissection; Neck function; Risk factors; Shoulder function.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Ipsilateral and contralateral flexion of the neck, example patients. ▲, Contralateral flexion of the neck, 70-year-old patient, surgery. SND ●, contralateral flexion of the neck, 70-year-old patient, surgery and radiotherapy. MRND ♦, ipsilateral flexion of the neck, 50-year-old patient. ■, Ipsilateral flexion of the neck, 70-year-old patient. SND, selective neck dissection; MRND, modified radical neck dissection; AROM, active range of motion
Fig. 2
Fig. 2
Ipsilateral shoulder abduction and forward flexion, example patients. ■, Ipsilateral abduction, 60-year-old male, primary closure, no ND. ♦, Ipsilateral abduction, 60-year-old female, bone graft/flap reconstruction, SND. ▲, Ipsilateral forward flexion, 60-year-old patient, myocutaneous or free flap reconstruction, T2 tumor, SND, TFM. ●, Ipsilateral forward flexion, 60-year-old patient, bone graft/flap reconstruction, T4 tumor, SND, mandibula. SND, selective neck dissection; TFM, tumor located in the tongue or floor of mouth; AROM, active range of motion
See this image and copyright information in PMC

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