Neurological Complications Following Neck Dissection in Oral Squamous Cell Carcinoma (OSCC) Patients

Abstract

Background: Neck dissection is a well‑established procedure for managing lymph node metastases in oral squamous cell carcinoma (OSCC) and other head and neck cancers. Despite its therapeutic value, the surgery can result in significant functional and aesthetic disturbances due to nerve injury. Limited data exist regarding postoperative neurological complications following neck dissection.
Objectives: To evaluate functional and aesthetic outcomes in relation to neurological complications after neck dissection in OSCC patients.
Materials and Methods: This observational study was conducted in the Department of Oral and Maxillofacial Surgery, Dhaka Dental College & Hospital, from July 2016 to June 2017. About 53 patients with histopathologically confirmed OSCC who underwent neck dissection with curative intent were included. Neurological outcomes were assessed monthly and documented for qualitative and quantitative analysis. Main outcome measures included aesthetic changes (incompetent lower lip, sagging of mouth corner) and functional limitations (shoulder syndrome, pain, limited arm extension, shoulder drooping, tongue deviation, ageusia, hypogeusia, auricular sensory alteration).
Results: Of 53 patients, 32 (60%) developed neurological complications. The most frequent was marginal mandibular nerve injury (24.5%), followed by spinal accessory nerve injury (22.6%). Complication rates were highest in radical neck dissection (100%). Supraomohyoid neck dissection was the most common procedure (66%). The alveolar ridge mucosa was the predominant primary site (38%), followed by buccal mucosa (24%) and retromolar area (24%).
Conclusion: Neurological complications are frequent after neck dissection, often leading to functional and aesthetic deficits. Routine postoperative assessment of sensorimotor nerve function is essential. Careful preoperative evaluation, meticulous surgical technique, and timely rehabilitation play a critical role in minimizing and managing these complications.

J. Contemp. Dent. Sci. 2026;14(2): 22-26