Syndrome of Inappropriate Secretion of ADH (SIADH) after Neck Dissection

Abstract

Objectives:To prospectively evaluate the incidence of syndrome of inappropriate ADH secretion (SIADH) in the postoperative period after neck dissections.Materials and Methods:The following parameters were obtained in the preoperative and postoperative period from 18 patients who had neck dissections with diagnoses of head and neck squamous cell carcinoma and also from 7 patients who were operated for various otolaryngological reasons. Personal files, tumor location, stage, surgical treatment, type of neck dissection, preservation or ligation of internal jugular vein (IJV) were recorded in the neck dissection group. In each group, Na+, K+, glucose, creatinine, BUN, uric acide, urine sodium, blood osmolarity and urine osmolarity levels were recorded preoperatively, as well as postoperatively during the first consecutive 7 days after the operation. The diagnosis of SIADH was established by evaluating the obtained laboratory data.Results:Postoperatively, SIADH was developed in 4 of 18 patients (22%) who had neck dissections whereas none of the 7 patients in the control group had an evidence of SIADH.Conclusion:Internal jugular vein was unilaterally ligated in all of 4 patients who developed SIADH. The ligation of the IJV was shown to increase the risk of SIADH development significantly, while this risk was found to be almost significant for patients with cervical metastasis.

Keywords

• siadh
• neck dissection
• head and neck cancer.