Case Report on Secondary Complications of Neck Dissection Surgery

ABSTRACT

The most common malignant neoplasm which affects structures of oral cavity is squamous cell carcinoma (SCC). Common sites of oral SCC are tongue and floor of mouth followed by buccal mucosa, gingiva and soft palate. Predisposing factors such as smoking, tobacco chewing along with alcohol consumption leads to carcinoma. SCC of gingiva located in keratinized portion is normally painless. Yoon et al described the clinical aspect of oral SCC which can vary from white plaque to an infected ulcerative lesion1. Gingiva squamous cell carcinoma shows features like exophytic mass with granular, papillary or present as ulcer. Patient comes to the doctor with predominant symptom like gum pain. Premolar and molar lesion are common sites and lower jaw is likely affected more than upper jaw.2Gingiva SCC is mostly asymptomatic in nature during early phase and frequently misdiagnosed as inflammatory lesion of oral cavity such as periodontitis, pyogenic granulomas, and inflammatory hyperplasia. Misinterpreted or delayed diagnosis and treatment leads to slow prognosis.3The gold standard treatment for Head and Neck cancer is surgery combined with radiotherapy or chemotherapy. Surgery often leads to dissection of lymph nodes because lymph nodes are the main source of further spread of metastasis. Patient who had undergone to neck dissection surgery for head and neck cancer should start early physical therapy rehabilitation program. Along with home program therapist assisted physical therapy sessions leads to early betterment of patient and early prognosis.4 Physical therapy plays important role in post-operative period. It reduces post-surgical immobility period in order to reduce further post-surgical complication as well as minimize chances of developing malfunction of shoulder joint. Follow up for long period is necessary. Early intervention of physical therapy is helpful for reducing pain, maintaining arm mobility.4Immediately after surgery of head and neck cancer, reduced range of head and neck as well as reduced and painful range of shoulder becomes more prominent. Post-operative functional impairment affect the quality of life so early rehabilitation including speech therapy, physiotherapy should be intensified as early as possible.5The most common malignant neoplasm which affects structures of oral cavity is squamous cell carcinoma. The gold standard treatment for Head and Neck cancer is surgery combined with radiotherapy or chemotherapy. Surgery often leads to dissection of lymph nodes because lymph nodes are the main source of further spread of metastasis. Patient who had undergone to neck dissection surgery for head and neck cancer should start early physical therapy rehabilitation program. Along with home program therapist assisted physical therapy sessions leads to early betterment of patient and early prognosis. Post-operative functional impairment affect the quality of life so early rehabilitation including speech therapy, physiotherapy should be intensified as early as possible. Post operatively patient tend to take rest without doing any mobility exercises due to pain which further leads to the restriction and complication of the joint.