Postoperative morbidity after different types of selective neck dissection.

OBJECTIVES/HYPOTHESIS: Although selective neck dissection (SND) is an oncologically efficient procedure for the N0 neck, its functional results are discussed controversially. The aim of the present study was to analyze the frequency of morbidity related to SND.

STUDY DESIGN: Retrospective single-institution series.

METHODS: The clinical data of 98 patients who had undergone unilateral SND of different dimensions and neck levels were analyzed. Radiotherapy was carried out in 37 (37.8%) patients. Functional and aesthetic results were evaluated in the context of aftercare consultation in 52 patients. The contralateral side of each patient served as the control. The mean follow-up period was 2.6 (0.5-9.1) years.

RESULTS: SND-related complications arose in two out of 50 patients (4%) with dissection of level IV in terms of an injury of the thoracic duct. Ten (19.2%) patients showed persistent slight lymph edema, and 34 (65.4%) patients noticed cervical incision sensibility disturbances after at least 6 months. Concerning head, neck, and shoulder function, no significant side differences were noticed by 31 (82%) patients for arm abduction, 32 (84%) for head rotation, and 30 (79%) for lateral head inclination. Subjectively, 50 (96.2%) patients had no restriction in head, neck, and shoulder movement after SND. Concerning the aesthetic results, only one (2%) patient was subjectively not satisfied.

CONCLUSIONS: SND of different dimensions and neck levels shows low incidence of surgical complications and acceptable functional and aesthetic results.