Sanjay Rastogi1, Ashish Sharma2, Rupshikha Choudhury3, Siddhi Tripathi4, Hessa Al Wayli5, Anand Amrithraj6, Mahendra P Reddy7. 1. Professor and Head, Department of Oral and Maxillofacial Surgery, KDCRC, Moradabad, UP, India. Electronic address: docos79@gmail.com. 2. Reader, Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, UP, India. 3. Lecturer, Department of Oral and Maxillofacial Surgery, Regional Dental College Guwahati, Assam, India. 4. Reader, Department of Prosthodontics, Kothiwal Dental College and Research Centre, Moradabad, UP, India. 5. Consultant, Oral Medicine and Radiology, Riyadh Dental Administration, Riyadh, Saudi Arabia. 6. Professor and Head, Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Karnataka, India. 7. DMD Student, University of Colorado, School of Dental Medicine, Denver, CO.
Abstract
PURPOSE: To estimate the clinical and functional results of patients who underwent distinctive types of neck dissection, with particular emphasis onshoulder function, rate of recurrence, and quality of life in patients with N0 neck. MATERIALS AND METHODS: A randomized clinical trial was conducted from August 2014 to March 2017 in which 20 adult patients with T1 to T3 lesions of the oral cavity and N0 neck were included. Patients were randomly allocated to group I (n = 10; selective neck dissection) or group II (n = 10; superselective neck dissection). All patients were evaluated objectively for degree of arm abduction and subjectively for quality of life using a questionnaire completed pre- and postoperatively at 6 months. Also, locoregional recurrence was investigated for 2.5 years. Data were scrutinized by applying mean and standard deviation, unpaired t test, Mann-Whitney U test, and Kaplan-Meier test. RESULTS:Mean values of the Arm Abduction Test and quality-of-life scores were statistically significant (P < .05) for group II compared with group I at all intervals. Data analyzed for locoregional recurrence showed a statistically significant difference between groups (P < .05), with group II having the better outcome. CONCLUSION: The results showed less shoulder morbidity and improved quality of life for superselective neck dissection (group II) compared with selective neck dissection (group I). Furthermore, group II was better for locoregional recurrence, which determines the oncologic safety of the procedure.
RCT Entities:
PURPOSE: To estimate the clinical and functional results of patients who underwent distinctive types of neck dissection, with particular emphasis on shoulder function, rate of recurrence, and quality of life in patients with N0 neck. MATERIALS AND METHODS: A randomized clinical trial was conducted from August 2014 to March 2017 in which 20 adult patients with T1 to T3 lesions of the oral cavity and N0 neck were included. Patients were randomly allocated to group I (n = 10; selective neck dissection) or group II (n = 10; superselective neck dissection). All patients were evaluated objectively for degree of arm abduction and subjectively for quality of life using a questionnaire completed pre- and postoperatively at 6 months. Also, locoregional recurrence was investigated for 2.5 years. Data were scrutinized by applying mean and standard deviation, unpaired t test, Mann-Whitney U test, and Kaplan-Meier test. RESULTS: Mean values of the Arm Abduction Test and quality-of-life scores were statistically significant (P < .05) for group II compared with group I at all intervals. Data analyzed for locoregional recurrence showed a statistically significant difference between groups (P < .05), with group II having the better outcome. CONCLUSION: The results showed less shoulder morbidity and improved quality of life for superselective neck dissection (group II) compared with selective neck dissection (group I). Furthermore, group II was better for locoregional recurrence, which determines the oncologic safety of the procedure.
Authors: Vishal M Bulsara; Helen V Worthington; Anne-Marie Glenny; Janet E Clarkson; David I Conway; Michaelina Macluskey Journal: Cochrane Database Syst Rev Date: 2018-12-24