Successful Treatment of Persisting Neck Pain after Radical Neck Dissection Using Prism Glasses

Abstract

Dear Editor We report the successful treatment with prism glasses of a patient with chronic, intractable, right-sided neck pain after radical neck dissection. Persisting neck and shoulder pain are well-recognized complications of neck dissection for malignant disease [1]. During neck dissection, the sternocleidomastoid muscle is usually removed. Given the sternocleidomastoid muscle's important role in head and neck proprioception [2], the possibility exists that persisting pain after a radical neck dissection might also represent a “phantom muscle” phenomenon. If this was the situation, then interventions similar to mirror therapy that are used to treat phantom limb pain [3] might have a role in treating persisting neck pain after radical neck dissection. A 72-year-old, retired, Indian, vegetarian male presented in November 2009 complaining of right-sided neck pain. He had undergone a right radical neck dissection and right hemiglossectomy for squamous cell carcinoma of the right lateral tongue in India in 2005. The right neck pain, rated “8–9 out of 10” in severity, had been present since this time and had not responded to previous medical interventions. He had a peripheral neuropathy managed with nortriptylline 20 mg nocte and gabapentin 300 mg tds. He was also on treatment for type …