Spinal Accessory Dysfunction Following Neck Dissection with Harmonic Scalpel V/S Electrocautery – A Single Centre Experience

Abstract

Aims: This study is an effort towards comparing the efficacy of the Harmonic Focus and Electrosurgical technique with regard to nerve injury especially spinal accessory nerve and its morbidity postoperatively after neck dissection. Sample: Ninety patients of oral carcinoma who required neck dissection were included in the study. Study Design: This is a prospective study. Place and Duration of Study: Bhagwan Mahaveer Cancer Hospital & Research Centre, Jaipur, Rajasthan, India for a period of 17 months from November 2016 to March 2018. Methodology: Patients’ post-operative recovery was studied prospectively by using parameters pertaining to shoulder function and shoulder pain. Results: There were significant differences in the pain and abduction deformity at various time periods after surgery. However differences in the quality of life did not show significant difference at the end of 3 months. For up to one month pain scores were lower for Harmonic Focus and shoulder function was better through 3 months. Conclusion: Though the technique of neck dissection (harmonic v/s electro cautery) has significant impact on shoulder dysfunction, despite that in postoperative period shoulder function measured by way of shoulder pain and shoulder abduction recover almost fully during follow-up period without causing significant morbidity and with minimal effect on quality of life. There are few recommendations we would like to suggest that if incorporated, they might significantly affect the outcome and better results.