14h40 The clinical and radiological prevalence of accessory nerve damage after selective neck dissections and radiotherapy on the neck.

Objective: Selective neck dissection (SND) is often the treatment of choice in head and neck cancer without metastatic lymph nodes with extranodal extension. During this procedure the accessory nerve is preserved, but it can be temporarily damaged during stripping of the nerve. The objective of this study is to determine the impact of SND and radiotherapy on the volume of the sternocleidomastoid (SCM) muscle after treatment and to correlate these results with the subjective complaints of the patients after surgery. The secondary objective is to evaluate the available literature on the therapeutic options when accessory nerve damage is suspected. 

Methods: All cases were previously treated for head and neck squamous cell carcinoma, including a SND, at the department of maxillofacial surgery at the university hospital of Antwerp. A volumetric analysis was performed of the SCM on CT and MRI images before and four months after treatment. All cases were contacted regarding past or present weakness/asymmetricity in the shoulder. The images were reviewed by two maxillofacial surgeons, independent of each other on two different occasions.