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The investigators suppose: 1. SND may cause damage to the soft tissue around shoulder girdle. 2. The soft tissue injury may be related with the order of severity of wing scapula and duration after SND. The aims of this study are: 1. To assess the functional disabilities of shoulder and upper extremity in different time period after SND. 2. To evaluate the soft tissue lesion of shoulder with soft tissue ultrasonography to prove our hypothesis. This study is a two years, prospective, cross-section study. The investigators will enroll 80 HNC post SND within 3months, >3- 6months,> 6months -1 year, more than 1 year as four different groups, 20 patient in each group.
Lymph node metastasis is one the most important prognostic-factors in head and neck cancer(HNC). Radical neck dissection (RND) has been the standard surgical method for HNC with neck lymph nodes metastasis in past decades. This operation includes removal of the sternocleidomastoid muscle (SCM), internal jugular vein (IJV) all cervical lymph nodes on one side and spinal accessory nerve (SAN), leading to significant ipsilateral shoulder syndrome caused by SAN dysfunction and impact quality of life. Despite most clinics prefer to use the nerve-sparing selective neck dissection (SND) for patient with N0 or N1 nodal disease today, shoulder disability and pain were still reported from 31% to 40% after this procedure. However, most previous studies evaluated the shoulder disability only by functional evaluation, range of motion, and questionnaire. The short and long term adverse effect to soft tissue around shoulder girdle after SND has not been reported. The investigators suppose: 1. SND may cause damage to the soft tissue around shoulder girdle. 2. The soft tissue injury may be related with the order of severity of wing scapula and duration after SND. The aims of this study are: 1. To assess the functional disabilities of shoulder and upper extremity in different time period after SND. 2. To evaluate the soft tissue lesion of shoulder with soft tissue ultrasonography to prove our hypothesis. This study is a two years, prospective, cross-section study. The investigators will enroll 80 HNC post SND within 3months, >3- 6months,> 6months -1 year, more than 1 year as four different groups, 20 patient in each group. Evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand (DASH) questionnaire. Statistical analysis will perform by SPSS software (SPSS V 20. International Business Machines. USA).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| post SND within 3 months | 20 Head and Neck Cancer(HNC) complicated with ipsilateral shoulder disability post SND within 3 months, evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
| |
| post SND within >3- 6months | 20 Head and Neck Cancer(HNC) complicated with ipsilateral shoulder disability post SND within >3- 6months, evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
| |
| post SND within 6 months -1 year | 20 Head and Neck Cancer(HNC) complicated with ipsilateral shoulder disability post SND within 6 months -1 year, evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
| |
| post SND within more than 1 year | 20 Head and Neck Cancer(HNC) complicated with ipsilateral shoulder disability post SND within more than 1 year, evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ultrasonography and elastography | Other | Evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
| Measure | Description | Time Frame |
|---|---|---|
| 2-Item findings of musculoskeletal ultrasonography and elastography | baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Range of motion | Each specific joint has a normal range of motion that is expressed in degrees.Devices to measure range of motion in the joints of the shoulder include the goniometer which use a stationary arm, protractor, fulcrum, and movement arm to measure angle from axis of the joint. | baseline |
| Manual Muscle Test |
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Inclusion Criteria:
head and neck cancer by Never-Sparing Selective Neck dissection, SND, the skin condition is stable, there is no wound, infection or inflammation metastasis.
Exclusion Criteria:
(1) in head and neck cancer before surgery and there had been other nerves, bones, muscles, tendons, resulting in lesions of the shoulder pain disorders or a history of activity. (2) severe cognitive function can not meet the examiner. (3) age less than 20 years of age or over 65 years of age.
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head and neck cancer by Never-Sparing Selective Neck dissection, SND, the skin condition is stable, there is no wound, infection or inflammation metastasis. Exclusion criteria: (1) in head and neck cancer before surgery and there had been other nerves, bones, muscles, tendons, resulting in lesions of the shoulder pain disorders or a history of activity. (2) severe cognitive function can not meet the examiner. (3) age less than 20 years of age or over 65 years of age.
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| Name | Affiliation | Role |
|---|---|---|
| Chau-Peng Leong, MD | Chang Gung Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chang Gung Memorial Hospital | Kaohsiung City | Niaonsung Hsiang | 83301 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7105450 | Result | Snow GB, Annyas AA, van Slooten EA, Bartelink H, Hart AA. Prognostic factors of neck node metastasis. Clin Otolaryngol Allied Sci. 1982 Jun;7(3):185-92. doi: 10.1111/j.1365-2273.1982.tb01581.x. | |
| 8275423 | Result | Leemans CR, Tiwari R, Nauta JJ, van der Waal I, Snow GB. Recurrence at the primary site in head and neck cancer and the significance of neck lymph node metastases as a prognostic factor. Cancer. 1994 Jan 1;73(1):187-90. doi: 10.1002/1097-0142(19940101)73:13.0.co;2-j. |
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No result now.
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D019220 | High-Energy Shock Waves |
| ID | Term |
|---|---|
| D000069453 | Ultrasonic Waves |
| D013016 | Sound |
| D011840 | Radiation, Nonionizing |
| D011827 | Radiation |
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|
| without shoulder disability | 20 Head and Neck Cancer(HNC) post SND without shoulder complication at the control group, evaluate the soft tissue of shoulder girdle with musculoskeletal ultrasonography and elastography, compare the finding in each group and the range of motion of their shoulder, the severity of wing scapula, visual pain analog scale and the score of The Disability of Arm, Shoulder and Hand |
|
|
Manual muscle testing is a procedure for the evaluation of the function and strength of individual muscles and muscle groups based on the effective performance of a movement in relation to the forces of gravity and manual resistance. |
| baseline |
| Pain Scale | A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data. | baseline |
| Disabilities of the Arm, Shoulder and Hand questionnaire（DASH） | The DASH Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in people with any of several musculoskeletal disorders of the upper limb. | baseline |
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| 10764008 | Result | Terrell JE, Welsh DE, Bradford CR, Chepeha DB, Esclamado RM, Hogikyan ND, Wolf GT. Pain, quality of life, and spinal accessory nerve status after neck dissection. Laryngoscope. 2000 Apr;110(4):620-6. doi: 10.1097/00005537-200004000-00016. |
| 843216 | Result | Gordon SL, Graham WP 3rd, Black JT, Miller SH. Acessory nerve function after surgical procedures in the posterior triangle. Arch Surg. 1977 Mar;112(3):264-8. doi: 10.1001/archsurg.1977.01370030036005. |
| 4051117 | Result | Sobol S, Jensen C, Sawyer W 2nd, Costiloe P, Thong N. Objective comparison of physical dysfunction after neck dissection. Am J Surg. 1985 Oct;150(4):503-9. doi: 10.1016/0002-9610(85)90164-3. |
| 6625099 | Result | Leipzig B, Suen JY, English JL, Barnes J, Hooper M. Functional evaluation of the spinal accessory nerve after neck dissection. Am J Surg. 1983 Oct;146(4):526-30. doi: 10.1016/0002-9610(83)90246-5. |
| 6486316 | Result | Short SO, Kaplan JN, Laramore GE, Cummings CW. Shoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve. Am J Surg. 1984 Oct;148(4):478-82. doi: 10.1016/0002-9610(84)90373-8. |
| 12383306 | Result | El Ghani F, Van Den Brekel MW, De Goede CJ, Kuik J, Leemans CR, Smeele LE. Shoulder function and patient well-being after various types of neck dissections. Clin Otolaryngol Allied Sci. 2002 Oct;27(5):403-8. doi: 10.1046/j.1365-2273.2002.00604.x. |
| 16785413 | Result | Inoue H, Nibu K, Saito M, Otsuki N, Ishida H, Onitsuka T, Fujii T, Kawabata K, Saikawa M. Quality of life after neck dissection. Arch Otolaryngol Head Neck Surg. 2006 Jun;132(6):662-6. doi: 10.1001/archotol.132.6.662. |
| 10961810 | Result | Cheng PT, Hao SP, Lin YH, Yeh AR. Objective comparison of shoulder dysfunction after three neck dissection techniques. Ann Otol Rhinol Laryngol. 2000 Aug;109(8 Pt 1):761-6. doi: 10.1177/000348940010900811. |
| 10443845 | Result | Kuntz AL, Weymuller EA Jr. Impact of neck dissection on quality of life. Laryngoscope. 1999 Aug;109(8):1334-8. doi: 10.1097/00005537-199908000-00030. |
| 16076539 | Result | Guldiken Y, Orhan KS, Demirel T, Ural HI, Yucel EA, Deger K. Assessment of shoulder impairment after functional neck dissection: long term results. Auris Nasus Larynx. 2005 Dec;32(4):387-91. doi: 10.1016/j.anl.2005.05.007. Epub 2005 Aug 1. |
| 15390203 | Result | van Wilgen CP, Dijkstra PU, van der Laan BF, Plukker JT, Roodenburg JL. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer. Head Neck. 2004 Oct;26(10):839-44. doi: 10.1002/hed.20052. |
| 19054587 | Result | van Wouwe M, de Bree R, Kuik DJ, de Goede CJ, Verdonck-de Leeuw IM, Doornaert P, Leemans CR. Shoulder morbidity after non-surgical treatment of the neck. Radiother Oncol. 2009 Feb;90(2):196-201. doi: 10.1016/j.radonc.2008.11.003. Epub 2008 Dec 4. |
| 17204991 | Result | Tsuji T, Tanuma A, Onitsuka T, Ebihara M, Iida Y, Kimura A, Liu M. Electromyographic findings after different selective neck dissections. Laryngoscope. 2007 Feb;117(2):319-22. doi: 10.1097/01.mlg.0000249781.20989.5c. |
| 17473671 | Result | Ferlito A, Johnson JT, Rinaldo A, Pratt LW, Fagan JJ, Weir N, Suarez C, Folz BJ, Bien S, Towpik E, Leemans CR, Bradley PJ, Kowalski LP, Herranz J, Gavilan J, Olofsson J. European surgeons were the first to perform neck dissection. Laryngoscope. 2007 May;117(5):797-802. doi: 10.1097/MLG.0b013e3180325b59. |
| 2036180 | Result | Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Official report of the Academy's Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg. 1991 Jun;117(6):601-5. doi: 10.1001/archotol.1991.01870180037007. |
| 3056289 | Result | Brown H, Burns S, Kaiser CW. The spinal accessory nerve plexus, the trapezius muscle, and shoulder stabilization after radical neck cancer surgery. Ann Surg. 1988 Nov;208(5):654-61. doi: 10.1097/00000658-198811000-00019. |
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| D055585 |
| Physical Phenomena |