Longitudinal Evaluation of Patient Concerns After Surgery For Head and Neck Cancer

The primary purpose of this study was to investigate and describe the longitudinal effects of shoulder and neck mobility, strength, and quality of life (QOL) following neck dissection (ND) surgery and identify the concerns of head and neck cancer (HNC) patients. ND is one of the standard procedures for treating HNC, which results in many complications and dysfunctions that can have an effect on a patient’s QOL. The study had 27 eligible HNC participants who underwent ND, of which eight participated in the shoulder range of motion (ROM) and strength and 12 participated in the QOL patient-reported outcomes analysis. The study followed participants’ pre-surgery, 1-month and 4-months post-surgery in order to determine the longitudinal effects of ND on shoulder (ROM, shoulder strength, neck ROM), and patients QOL. The study administered the Patient Concerns Inventory- Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington- Quality of Life questionnaire (UWQOL) to obtain patient-reported outcomes on QOL. Additionally, measures of ROM and strength on shoulder flexion and external rotation, along with neck ROM were used to determine shoulder and neck dysfunction. The study identified that patients report increases in shoulder pain and dysfunction post-surgery (1-month follow-up) and continued up to 4-months post-surgery. Additionally, patient-reported QOL decreased post ND and is perceived to be low by patients up to 4-months post ND. Identification of patient concerns and the changes in mobility, pain and QOL should assist in the management of the post-surgical recovery plan for HNC patients following ND. Additionally, the study suggests the importance of expanding the health care team for HNC patients in order to improve the pain, dysfunction and decrease in QOL experience by these patients