Research Article| Volume 58, ISSUE 9, P1172-1179, November 2020

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Complaints of neuropathic pain, noxious cervical plexus neuropathy and neck tightness are reported by patients who undergo neck dissection: an institutional study and narrative review

  • Author Footnotes
    1 Avisham Ramphul and Gary Hoffman contributed equally to the work and share first authorship
    A. Ramphul
    Corresponding author at: Po Box 684 Charlestown, NSW, 2290
    1 Avisham Ramphul and Gary Hoffman contributed equally to the work and share first authorship
    Registrar, Oral and Maxillofacial Surgery, John Hunter Hospital, Newcastle
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  • Author Footnotes
    1 Avisham Ramphul and Gary Hoffman contributed equally to the work and share first authorship
    GR Hoffman
    1 Avisham Ramphul and Gary Hoffman contributed equally to the work and share first authorship
    Visiting Medical Officer (Attending), Head and Neck Surgery, Department of Maxillofacial Surgery, John Hunter Hospital, Newcastle

    Professor, Medical School, University of Newcastle
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  • S. Islam
    Consultant, Head and Neck Surgery, Department of Maxillofacial/Head and Neck Surgery, University Hospitals Coventry and Warwickshire NHS Trust
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  • AC McGarvey
    Senior Physiotherapist, Calvary Mater Hospital, Newcastle
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  • AD Powell
    Visiting Medical Officer (Attending),Anaesthetics and Hunter Integrated Pain Service, John Hunter Hospital, Newcastle
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  • Author Footnotes
    1 Avisham Ramphul and Gary Hoffman contributed equally to the work and share first authorship
Published:September 14, 2020DOI:


      There exists a subgroup of patients who undergo neck dissection (ND) who postoperatively complain of either neuropathic pain, dysaesthesia and/or discomfort that is located within the dermatomal distribution of the cervical plexus. The purpose of our study was to determine the prevalence, characteristic, and demographics of these symptoms in our patient cohort. We undertook a retrospective randomised observational cohort study of 105 patients who had undergone ND. The primary predictor variable was the undertaking of a ND. The secondary outcome variable was the complaint of either neuropathic pain or a noxious neuropathy, at a minimum of twelve months after surgery. A recognised symptom questionnaire and a visual analogue score was employed for the purpose of the study. A descriptive and statistical analysis was applied to the assembled data. Twenty patients (19%) complained of either spontaneous (n = 9) or evoked (n = 11) neuropathic pain that occurred within the surgical site. In addition, 71 patients (68%) described an altered sensation in the dermatomal distribution of the great auricular or tranverse cervical nerves while 70 patients (67%) described the feeling of ‘neck tightness’. There were no characteristics of the study cohort that underpinned these results. Neuropathic pain can occur following ND. This can cause distress to a small but defined group of patients. Despite its importance, we found a paucity of studies in the literature that have investigated neuropathic pain following ND. We believe this condition requires more research attention and clinical awareness


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