Inspiratory muscle weakness, diaphragm immobility and diaphragm atrophy after neck dissection.

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Inspiratory muscle weakness, diaphragm immobility and diaphragm atrophy after neck dissection.

Eur Arch Otorhinolaryngol. 2018 Mar 05;:

Authors: Santana AFSG, Caruso P, Santana PV, Porto GCLM, Kowalski LP, Vartanian JG

Abstract
BACKGROUND: Inspiratory strength after a neck dissection has not been evaluated, and diaphragm function has not been adequately evaluated.
OBJECTIVE: Evaluate diaphragm mobility and inspiratory strength after neck dissection.
METHODS: Prospective data collection of a consecutive series of adult patients submitted to neck dissection for head and neck cancer treatment, in a tertiary referral cancer center, from January to September 2014, with 30 days of follow-up. A total of 43 were studied (recruited 56; excluded 13).
MAIN OUTCOME MEASURES: Determine diaphragm mobility and inspiratory muscle strength after neck dissection, using diaphragm ultrasound and by measuring maximal inspiratory pressure (MIP) and sniff nasal inspiratory pressure (SNIP).
RESULTS: Thirty patients underwent unilateral neck dissection, and thirteen patients underwent bilateral neck dissection. Diaphragm immobility occurred in 8.9% of diaphragms at risk. For the entire cohort, inspiratory strength decreased immediately after the dissection but returned to preoperative values after 1 month. Except for those with diaphragm immobility, diaphragm mobility remained unchanged after the dissection. One month after the dissection, the diaphragm thickness decreased, indicating diaphragm atrophy.
CONCLUSIONS: Immediately after a neck dissection, just a few patients showed diaphragmatic immobility, and there was a transient decrease in inspiratory strength in all individuals. Such findings can increase the risk of postoperative complications in patients with previous lung disease.

PMID: 29508056 [PubMed - as supplied by publisher]

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