Clavicle fracture with osteomyelitis after neck dissection and post-operative radiotherapy: case report

2017 ◽  
Vol 131 (11) ◽  
pp. 1026-1029 ◽  
Author(s):  
R Shodo ◽  
Y Sato ◽  
H Ota ◽  
A Horii
Keyword(s):  
Case Report ◽  
Neck Dissection ◽  
Cancer Patients ◽  
Bone Fractures ◽  
Clavicle Fracture ◽  
Radical Neck Dissection ◽  
Stress Fractures ◽  
Abscess Formation ◽  
Accessory Nerve ◽  
Antibiotic Administration

AbstractBackground:Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged.Case report:A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation.Conclusion:As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.

scholarly journals Medial clavicle fracture with bone destruction after radical neck dissection combined with postoperative chemotherapy for secondary cervical lymph node metastasis of tongue cancer: a case report

2021 ◽  
Author(s):  
Masayasu Tashiro ◽  
Tomoaki Sano ◽  
Kazutaka Sugiura ◽  
Yasuhito Minamida ◽  
Yoshihiro Abiko ◽  
...  
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Neck Dissection ◽  
Cervical Lymph Node ◽  
Tongue Cancer ◽  
Rare Complication ◽  
Clavicle Fracture ◽  
Radical Neck Dissection ◽  
Bone Destruction ◽  
The Right

Abstract Background Clavicle fractures (CF) after radical neck dissection (RND) for oral cancer are rare but are thought to occur as a result of myotonia and decreased blood supply to the muscles around the clavicle after RND. The current report presents a rare case of a non-neoplastic pathological CF after RND, and discusses the role of imaging examinations for the timely detection of CF. Case report An 82-year-old Japanese man underwent RND followed by chemotherapy without radiotherapy for secondary metastasis of the right cervical lymph node after resection of tongue cancer. Computed tomography at 6 months after RND revealed a fracture with bone destruction in the proximal end of the right clavicle. He had no history of trauma at the site of the fracture and no symptoms. The possibility of bone metastasis of the clavicle was considered; however, the bone destruction had not advanced 6 years after the discovery of the fracture. The CF was thus finally considered to be a side effect of RND, rather than metastasis. Conclusion CF is a rare complication following treatment for head and neck cancer but can be caused by neck dissection. Regular imaging examinations, including the clavicular region, are therefore needed before and after surgery to ensure the timely detection of CF.

Segmental dystonia after radical neck dissection and radiotherapy: a case report

2020 ◽  
Author(s):  
Francesca Di Biasio ◽  
Ottavia Baldi ◽  
Laura Avanzino ◽  
Roberta Marchese
Keyword(s):  
Case Report ◽  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Segmental Dystonia

Spinal accessory nerve function after neck dissections

2006 ◽  
Vol 121 (1) ◽  
pp. 44-48 ◽  
Author(s):  
K S Orhan ◽  
T Demirel ◽  
B Baslo ◽  
E K Orhan ◽  
E A Yücel ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Shoulder Function ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Nerve Function ◽  
Double Blind ◽  
Spinal Accessory ◽  
The Third ◽  
Object Lifting

The aim of this study was to evaluate spinal accessory nerve function after functional neck dissection (FND) and radical neck dissection (RND) by monitoring the nerve with electromyographic (EMG) examinations. A prospective, double-blind, clinical study was undertaken in 21 patients (42 neck side dissections) operated on for head and neck malignant diseases, separated into two groups: 10 neck sides in the RND group and 32 neck sides in the FND group. Electromyographic examinations were performed pre-operatively and post-operatively in the third week and third and ninth months. Additionally, a questionnaire, modified from the neck dissection impairment index, was applied to all the patients in order to assess shoulder function in the ninth post-operative month.All patients had maximum EMG scores pre-operatively. Following the operation, motor amplitudes decreased in both groups. At the third post-operative month, amplitudes decreased to their lowest values. As expected, the decreases in amplitude and EMG score were more prominent in the RND group. Following reinnervation, the amplitudes of the trapezius motor response increased in the FND group but never reached pre-operative values (during the time of follow up). The FND group scores for pain, neck and shoulder stiffness, and disability in heavy object lifting, light object lifting and reaching overhead were significantly lower than those of the RND group.In FND, one aims to preserve anatomically the spinal accessory nerve, and it is presumed to be intact after the procedure. However, using EMG nerve function monitoring, our study revealed that profound spinal nerve injury was detected immediately after FND surgery, which tended to improve over subsequent months but had not regained its original function by the end of the ninth post-operative month.

scholarly journals Blindness after laryngectomy and bilateral neck dissection in a diabetic patient: case report

2001 ◽  
Vol 119 (5) ◽  
pp. 181-183 ◽  
Author(s):  
Rui Celso Martins Mamede ◽  
David Livingstone Alves Figueiredo ◽  
Fabrício Villela Mamede
Keyword(s):  
Case Report ◽  
Diabetic Patient ◽  
Neck Dissection ◽  
Total Laryngectomy ◽  
Malignant Tumors ◽  
Rare Complication ◽  
Radical Neck Dissection ◽  
Selective Neck Dissection ◽  
Intraoperative Hypotension ◽  
The Right

CONTEXT: Neck dissection that accompanies resection of the primary lesion in malignant tumors of the upper aerodigestive tracts may cause complications inherent to the procedure or to prolongation of surgical time, increasing the risks for the patient. Among the complications that might occur is blindness, a rare complication with only 10 cases reported in the literature thus far. OBJECTIVE: To present the case of a diabetic patient submitted to total laryngectomy and modified and selective neck dissection that resulted in blindness. CASE REPORT: The authors report on a patient submitted to total laryngectomy and selective neck dissection on the left side, and modified radical neck dissection on the right, who developed blindness. This was probably due to intraoperative hypotension plus the contribution of decompensated diabetes mellitus and thrombosis of the internal jugular vein on the right side. The possible causes, risk factors and care to be taken to prevent this rare but highly debilitating complication are discussed.

Rehabilitation of the Shoulder after Radical Neck Dissection

1975 ◽  
Vol 84 (6) ◽  
pp. 812-816 ◽  
Author(s):  
W. H. Saunders ◽  
E. W. Johnson
Keyword(s):  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Sternocleidomastoid Muscle ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Spinal Accessory

After classical radical neck dissection with removal of the sternocleidomastoid muscle and division of the spinal accessory nerve, there are certain disabling or disagreeable musculoskeletal defects. This paper describes the muscular deficiencies and gives a set of exercises which can be counted on to minimize the problems.

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