American Cancer Society Head and Neck Cancer Survivorship Care Guideline.

Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.

Late-onset spinal accessory nerve palsy after traffic accident: case report.

An injury to the spinal accessory nerve is mostly reported after surgical procedures performed in the posterior triangle of the neck. In addition, it may be caused by fractures in the jugular foramina, traumas or skull base tumors. Clinically, paralysis of the trapezius muscle leads to weakness, downward rotation of the scapulae and falling down of the shoulder girdle. A 38- year-old male with left shoulder pain, scapular deviation and weakness in the left upper extremity, whose symptoms developed over a two-year period following a traffic accident, is presented herein. In the electromyography (EMG) study, partial spinal accessory nerve palsy was detected. The patient was treated conservatively for the nerve palsy since the time elapsed rendered surgical intervention inappropriate. We report a case in which spinal accessory nerve palsy developed two years after a traffic accident. Accessory nerve injury following a traffic accident is very uncommon.

Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: a literature review.

BACKGROUND: Neck dissection is an operation that can result in accessory nerve injury. Accessory nerve shoulder dysfunction (ANSD) describes the pain and impaired range of motion that may occur following neck dissection. The aim of this review was to establish the level of evidence for the effectiveness of physiotherapy in the postoperative management of ANSD. METHODS: A literature search of physiotherapy and ANSD using Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and Cochrane Library databases was undertaken. RESULTS: Physiotherapy has been shown to be well tolerated in this patient group following surgery. However, few studies exist as to the effect of physiotherapy on ANSD. CONCLUSIONS: There is a need for research to investigate the effects of early, appropriate physiotherapy on the development of ANSD following neck dissection surgery. Such a study has the potential to improve the functional outcome and quality of life in this patient group, and ultimately to promote best practice guidelines for management.