The Role of the Headmaster Collar (Cervical) for Dropped Head Syndrome in Hodgkin Lymphoma Survivors

BACKGROUND: Dropped head syndrome is a potential late neurologic complication of radiation therapy in survivors of Hodgkin lymphoma. There is limited evidence for conservative management of this condition. OBJECTIVE: To discover patient utilization patterns of the commonly prescribed Headmaster Collar (cervical) in Hodgkin lymphoma survivors with radiation-induced dropped head syndrome. DESIGN: Questionnaire-based retrospective observational study. SETTING: Single-site academic cancer center. PATIENTS: Twenty-six Hodgkin lymphoma survivors treated with radiation therapy involving the mantle who were prescribed a Headmaster Collar for dropped head syndrome. METHODS OR INTERVENTIONS: Patients were interviewed by phone with a structured set of questions. MAIN OUTCOME MEASUREMENTS: Compliance, patterns of use, individual modifications, and side effects of collar use. RESULTS: Although 58% of patients who were prescribed a Headmaster Collar eventually discontinued its use, 62% of all patients used the collar for more than 6 months. The majority of users wore the collar for up to 3 hours per day, usually for static seated activities. Thirty-eight percent of patients made personal modifications to their collar, most commonly the addition of extra padding. All but one patient had complaints about the collar, most commonly discomfort, rigidity, and confinement. CONCLUSIONS: The Headmaster Collar (cervical) is often utilized for a few hours a day, for longer than 6 months, to help with static seated activities. Insights from this study might help to improve future orthotic designs with better long-term compliance rates for the treatment of radiation-induced dropped head syndrome. LEVEL OF EVIDENCE: IV.