Evidence map›Paper›PMID 42005250›Full record

ArticleCureus2026

The Impact of Neck Dissection on the Functional Integrity of Spinal Accessory Nerve in Head and Neck Cancers.

Sandeepan Bhattacharya, Vikas Gupta, Utkal P Mishra, Ganakalyan Behera, Ruchi Singh, Rajesh Malik

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sandeepan BhattacharyaOtolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Vikas GuptaOtolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Utkal P MishraOtolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Ganakalyan BeheraOtolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Ruchi SinghPhysiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Rajesh MalikRadiodiagnosis, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and objective Neck dissection remains a cornerstone in the management of head and neck cancers with cervical lymph node metastasis. Despite advances in nerve-sparing surgical techniques, shoulder dysfunction remains a recognized complication following neck dissection. This study aimed to evaluate whether anatomical preservation of the spinal accessory nerve (SAN) correlates with its functional integrity and postoperative shoulder function following neck dissection in head and neck cancer patients. Methods This prospective, longitudinal observational study enrolled 25 patients undergoing selective neck dissection (SND) or modified radical neck dissection (MRND) for biopsy-proven head and neck malignancies. Preoperative and postoperative assessments conducted at two and four weeks included clinical shoulder examination, goniometric range of motion (ROM), Shoulder Pain and Disability Index (SPADI), and electromyography (EMG) of the trapezius muscle. Radiological assessment of sternocleidomastoid (SCM) and trapezius muscle volume was performed preoperatively and at six months. Intraoperative nerve monitoring (IONM) was employed in all cases. Results All patients had normal preoperative shoulder function. At two weeks postoperatively, significant deterioration was observed in shoulder abduction, shrug strength, cervical rotation, and SPADI scores (p < 0.001). Partial recovery was noted at four weeks; however, deficits persisted in a subset of patients. Postoperative EMG demonstrated significant changes on the operated side (p = 0.031). At six months, a statistically significant reduction in the trapezius muscle volume was observed (p < 0.001), with a greater percentage reduction in volume in the MRND group compared to the SND group. IONM parameters did not significantly differ between dissection types and did not consistently correlate with postoperative functional outcomes. Conclusions Anatomical preservation of the SAN does not necessarily ensure functional integrity. Early postoperative shoulder dysfunction occurs even in nerve-sparing procedures, with more pronounced structural changes following a modified radical neck dissection. Multimodal postoperative assessment and early rehabilitation are essential. Larger studies with longer follow-up periods are warranted to further clarify the prognostic role of IONM.

Indexed as

accessory nerveelectromyographyhead and neck neoplasmsintraoperative neuromonitoringneck dissectionshoulder dysfunction

Identifiers

PMID42005250
PMCPMC13086516

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