Morbidity of neck dissection submuscular recess (sublevel IIb) in head and neck cancer

2014 
The impact of neck dissection on quality of life has often been considered less important than the oncological control. Dissection of level IIb doesn't improve oncologic control everytime, knowing that an injury of the spinal nerve can occur. The aim of our study was to assess the impact of neck dissection including level IIb on shoulder function and quality of life in N0 patients.Fifteen patients with squamous cell carcinoma of the upper aerodigestive tract, clinical and radiological NO, were included. They were assessed by validated scales (QLQ-C30, H&N35 and DASH) and they underwent an examination of the shoulder.Almost half of the patients had pain in the shoulder. The functional scale score QLQ-C30 was statistically more altered (49.7%) than that of patients with cancer in general (74.9%, p = 0.00016) and of the general population 60 to 69 years (85.4%, p = 0).The results of our study underscore the morbidity on shoulder function after neck dissection. These findings, combined with the low prevalence of occult lymph node metastases in level IIb among T1-T2 patients, must question the systematic inclusion of this level in neck dissection.
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