In modified neck dissection, surgeon should be careful to avoid ‘shoulder syndrome’. All of the following are pa of shoulder syndrome, EXCEPT:
**Core Concept**
Modified neck dissection is a surgical procedure that involves the removal of lymph nodes from the neck, often used to treat head and neck cancers. Shoulder syndrome, also known as shoulder dysfunction or frozen shoulder, is a potential complication of this procedure. It is characterized by pain, stiffness, and limited mobility of the shoulder joint.
**Why the Correct Answer is Right**
Shoulder syndrome is a multifactorial condition that can arise after neck dissections due to injury to the brachial plexus, damage to the axillary artery or vein, and scarring of the shoulder joint. The brachial plexus is a network of nerves that supply the arm, and injury to these nerves can lead to weakness, numbness, and pain in the affected arm. The axillary artery and vein are crucial for blood flow to the arm, and damage to these vessels can lead to ischemia and further contribute to shoulder dysfunction.
**Why Each Wrong Option is Incorrect**
* **Option A:** Adhesive capsulitis is a key component of shoulder syndrome, characterized by inflammation and scarring of the shoulder joint capsule, leading to pain and stiffness.
* **Option B:** Atrophy of the deltoid muscle is a possible consequence of shoulder syndrome, as the muscle may become weak and underused due to pain and limited mobility.
* **Option D:** Fibrosis of the subacromial bursa is another aspect of shoulder syndrome, where scarring of the bursa can lead to friction and pain as the shoulder joint moves.
**Clinical Pearl / High-Yield Fact**
When performing a modified neck dissection, it is essential to identify and preserve the branches of the brachial plexus to prevent shoulder syndrome. The surgeon should also carefully ligate the axillary artery and vein to minimize the risk of damage.
**Correct Answer:** C.