頸部郭清後に生じた頸部痛の制御に苦慮した1例

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  • A case of intolerable cervical pain occurring after neck dissection
  • ケイブカクセイ ゴ ニ ショウジタ ケイブツウ ノ セイギョ ニ クリョ シタ 1レイ

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The outcomes of radical neck dissection have recently improved considerably; postoperative sequelae such as shoulder joint disorders have become a problem. Sequelae of radical neck dissection include decreased range of motion of the upper limbs/neck caused by trapezius muscle disorders, muscular weakness, and impaired ability to elevate the upper limbs. Numbness and pain in the neck/shoulders can also arise.We describe a case of severe, unmanageable cervical pain that arose in a 49-year-old man immediately after total neck dissection for late cervical lymph node metastasis 6 months after undergoing partial tongue dissection to treat cancer of the left side of the tongue.<br>Immediately after surgery, the patient complained of intolerable pain at the site of the cervical skin incision. An anti-inflammatory analgesic drug did not relieve the pain. An antidepressant agent together with physical rehabilitation and trapezius muscle massage were prescribed as supportive therapies for the cervical and shoulder joint disturbances. The cervical pain then subsided. Our experience suggests that the early administration of antipsychotic agents and rehabilitation might be effective for the management of pain after radical neck dissection.

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