• HNO · Jun 2002

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

    • Parwis Agha-Mir-Salim, W Schulte-Mattler, U Funk, C Lautenschläger, M Bloching, and A Berghaus.
    • Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Strasse 12, 06097 Halle. p.mir-salim@medizin.uni-halle.de
    • HNO. 2002 Jun 1;50(6):544-52.

    BackgroundThe 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).Material And MethodsThe 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.ResultsMotion-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.DiscussionOur 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.

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