Origin of shoulder pain after "neck dissection". Importance of the cervical plexus

The role of sensitive parts of the cervical plexus for the development of neuropathic pain is not yet clear. Our study investigated the correlation between shoulder pain and cervical plexus damage after different types of neck dissection (ND). The sensitivity for warm/cold and sharp/blunt was tested...

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Bibliographic Details
Published in:HNO 2002-06, Vol.50 (6), p.544-552
Main Authors: Agha-Mir-Salim, Parwis, Schulte-Mattler, W, Funk, U, Lautenschläger, C, Bloching, M, Berghaus, A
Format: Article
Language:ger
Subjects:
Cervical Plexus - injuries
Cervical Plexus - physiopathology
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Neck Dissection - adverse effects
Otorhinolaryngologic Neoplasms - radiotherapy
Otorhinolaryngologic Neoplasms - surgery
Pain Measurement
Pain Threshold - physiology
Pain, Postoperative - etiology
Pain, Postoperative - physiopathology
Radiculopathy - physiopathology
Radiotherapy, Adjuvant
Sensory Receptor Cells - physiopathology
Sensory Thresholds - physiology
Shoulder Pain - etiology
Shoulder Pain - physiopathology
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Summary:The role of sensitive parts of the cervical plexus for the development of neuropathic pain is not yet clear. Our study investigated the correlation between shoulder pain and cervical plexus damage after different types of neck dissection (ND). The sensitivity for warm/cold and sharp/blunt was tested in the dermatomes of C2, C3, C4, and the minor occipital nerve. Shoulder pain was measured semiquantitatively by a rating scale. Motion-dependent shoulder pain was observed 6 months postoperatively in 50% after resection and in 29.2% after preservation of these structures. Pain occurred more frequently following radical ND than after modified radical types 1 and 3 ND. Our investigations showed that the superficial cervical plexus function is assessable by cutaneous sensitivity tests. The minor occipital nerve seemed to be less affected. Fewer pain symptoms in cases with preserved cervical plexus could be demonstrated. We can conclude that preservation of the superficial cervical plexus is important to diminish postoperative shoulder pain.
ISSN:0017-6192