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Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Sep;131(4):243-7. doi: 10.1016/j.anorl.2014.07.003. Epub 2014 Aug 6.

Management of somatic pain induced by head-and-neck cancer treatment: definition and assessment. Guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (SFORL).

Author information

1
Service d'anesthésie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France. Electronic address: marie.binczak@gmail.com.
2
Centre de la douleur, CHU de Saint-Étienne, 42055 Saint-Étienne cedex, France.
3
Clinical psychologist, CHU Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France.
4
Service d'ORL et de chirurgie de la face et du cou, centre François-Baclesse - centre de lutte contre le cancer Basse-Normandie, 3, avenue Général-Harris, BP 5026, 14076 Caen cedex 05, France.
5
Radiothérapie-oncologie, centre de radiothérapie Hartmann, 4, rue Kléber, 92300 Levallois-Perret, France.
6
Service de médecine physique et de réadaptation, hôpital de Bellevue, CHU, 42055 Saint-Étienne cedex, France.
7
Physiotherapist, CHU Nord, place Victor-Pauchet, 80054 Amiens cedex, France.
8
Service de cancérologie, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
9
Service d'ORL et de chirurgie cervico-faciale, CHU, 1, place Alexis-Ricordeau, 44093 Nantes cedex, France.
10
Service de chirurgie maxillo-faciale, hôpital Nord, CHU, place Victor-Pauchet, 80054 Amiens cedex, France.
11
Service d'ORL et de chirurgie de la face et du cou, groupe hospitalier Bichat - Claude-Bernard, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
12
Service d'ORL et de chirurgie de la face et du cou, hôpital Bretonneau, CHU, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.

Abstract

OBJECTIVES:

The authors present the guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (Société Française d'Oto-rhino-Laryngologie et de Chirurgie de la Face et du Cou [SFORL]) for the management of somatic pain induced by head-and-neck cancer treatment, and in particular the instruments needed for the definition and initial assessment of the various types of pain.

METHODS:

A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence.

RESULTS:

The priority is to eliminate tumoral recurrence when pain reappears or changes following head-and-neck cancer treatment. Neuropathic pain screening instruments and pain assessment scales should be used to assess pain intensity and treatment efficacy. Functional rehabilitation sessions should be prescribed to reduce musculoskeletal pain and prevent ankylosis and postural disorder. Psychotherapy and mind-body therapy, when available, should be provided in case of chronic pain. In case of recalcitrant complex pain, referral should be made to a multidisciplinary pain structure.

CONCLUSION:

The management of somatic pain induced by head-and-neck cancer treatment above all requires identifying and assessing the intensity of the various types of pain involved, their functional impact and their emotional component.

KEYWORDS:

Acute pain; Assessment; Chronic; Neuropathic pain; Psychogenic pain

PMID:
25108356
DOI:
10.1016/j.anorl.2014.07.003
[Indexed for MEDLINE]
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