Head And Neck Cancer

Front 1

Name the three main treatment options for persons with head or neck cancers.

Back 1

1. Surgical (radical neck dissection, modified radical neck dissection, and reconstruction)

2. Radiation therapy

3. Chemotherapy (less prevalent then radiation therapy for this patient population)

Front 2

What is removed during the radical neck dissection?

Back 2

SCM, omohyoid muscles, all lymph nodes, internal and external jugular veins, and the spinal accessory nerve.

Front 3

What is removed during the modified radical neck dissection?

Back 3

Removal of the SCM, omohyoid muscles, and the internal and external jugular veins. THe spinal accessory nerve and some levels of the lymph nodes are often preserved.

Front 4

How do surgical interventions impact the lymphatic system?

Back 4

The incisions disrupt superficial capillaries, lymph nodes are often removed, there can be formation of extensive superficial and deep scar tissue, and some of the venous pathways may be removed.

Front 5

How long can the effects of radiation therapy potentially last?

Back 5

Effects of XRT may continue to develop up to 18 months.

Front 6

List some rehab interventions for head and neck cancer sequela.

Back 6

Cervial ROM
Scapular stability
Shoulder function
Scar mobility
TMG ROM and function
Speech
Swallowing

Front 7

What is SAN Palsy?

Back 7

Surgical disruption of optimal firing of the SAN. Causes trapezius dysfunction with resultant scapular dyskinesis.

Front 8

What will happen at the shoulder complex with SAN Palsy?

Back 8

Loss of scapular stability, scapular abduction and internal rotation, and secondary shoulder pathologies.

Front 9

What interventions can be used to treat SAN Palsy?

Back 9

Optimize postion of scapula (use taping, verbal cueing for posture, etc.), training of accessory muscles if the innervation to the trapezius is not intact, RTC strengthening, pectoral stretching, patient education (positioning and protection of shoulder, postural eduction, and lifting precautions).