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The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a consequence of neck dissection

Published online by Cambridge University Press:  29 June 2007

Thomas W. Mesko ,
Orlando Garcia ,
Lisa D. Yee ,
MaryJo Villar  and
Helen Chan
Thomas W. Mesko*
Affiliation:
Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, Florida.
Orlando Garcia
Affiliation:
Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida.
Lisa D. Yee
Affiliation:
Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, Florida.
MaryJo Villar
Affiliation:
Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida.
Helen Chan
Affiliation:
Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, Florida.
*
Address for correspondence: Thomas W. Mesko, M.D., Section of Surgical Oncology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, Florida 33140 Fax: (305) 674-2863
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Abstract

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) canhave multiple causes. Surgical neck dissections may have an association with this syndrome and represent the basis for this study. A retrospective review of 50 patients undergoing neck dissections was performed to evaluate for the development of hyponatraemia as a consequence of SIADH. Based on the results of this review, a prospective study of 20 consecutive patients undergoing 22 neck dissections was performed to determine the incidence ofSIADH. A control group of 25 consecutive patients undergoing major non-neck dissection surgery was also studied. SIADH developed in nine of 50 patients (18 per cent) of our retrospective group with a high incidence of development in those who had jugular vein ligation (JVL) (22 per cent), pre-operative radiation therapy (25 per cent) or squamous cell cancers (32 per cent). SIADH developed in six patients undergoing 22 neck dissections (27 per cent) in our prospective group. A high incidence was also noted for those with JVL (42 per cent), pre-operative radiation therapy (67 per cent) or squamous cell cancer (40 per cent). No patients developed symptomatic hyponatraemia. No patients in the prospective control group developed SIADH. Neck dissection surgery is associated with a significant risk for the development of SIADH. Factors such as jugular vein ligation (JVL), pre-operative radiotherapy and squamous cell cancer appear to increase this risk.

Keywords

Head and neck neoplasmsHyponatraemiaArginine vasopressin
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 5 , May 1997 , pp. 449 - 453
Copyright
Copyright © JLO (1984) Limited 1997

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