Abstract
OBJECTIVE: The primary aim of our prospective study was to assess the impact of Dropped Head Syndrome (DHS), a rare condition in Head and Neck Cancer (HNC) clinics, on patients' functional status and body image. Our secondary aim is to investigate the relationship between head and neck lymphoedema (HNL) and DHS, which will be examined for the first time in the literature. METHODS: We conducted a study involving 47 patients, aged between 18 and 75, who had been diagnosed with HNC, and exhibited clinical symptoms of DHS for at least 12 months. The staging of HNL was assessed using the MD Anderson Cancer Center HNL (MDACC HNL) staging system. We also administered The Total Functional Scale (TFS) which was a subscale of EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30) and the Body Image Scale (BIS). RESULTS: In the study, it was observed that the BIS was significantly lower in patient groups aged 50 and over (p = 0.0495), those with a laryngectomy (p = 0.0002), those who had undergone bilateral neck dissection (p = 0.0291), and particularly in patients with stage 2-3 lymphedema (p < 0.0001). Similarly, it was noted that passive cervical extension limitation had a statistically significant impact on both the BIS (p < 0.0001) and the TFS (p < 0.0001). It was also found that BIS (p < 0.0001) and TFS (p < 0.0001) improved in the late postoperative period (12 months ≤) and this improvement was statistically significant. CONCLUSIONS: In this study, we found statistical relationships between age, laryngectomy, surgery procedures, lymphedema stages, passive cervical extension limitations, total functional score, and BIS. Early diagnosis of DHS allows for supportive care and physiotherapy methods, which can lead to improvement. HNL and DHS should be prevented to improve quality of life and body image and increase survival. Therefore, further research with a much larger patient population is needed.