Spinal accessory nerve stimulation during neck dissection (SANE)
Surgery for head and neck cancer often involves removing lymph nodes from the neck. During this procedure, an important nerve controlling shoulder movement can get stretched or irritated. This can cause long-term arm weakness, stiffness, and pain. Researchers want to see if gently stimulating this nerve with a small electric current for 10 minutes while the patient is asleep under general anaesthetic could help it heal. This small trial, called the SANE study, is taking place at Churchill Hospital in Oxford. It aims to see if running this type of study is feasible within the NHS and acceptable to surgical teams. Half of the 14 participants will receive standard care, while the other half will have standard care plus the 10-minute nerve stimulation. Researchers will track shoulder recovery over 12 months to prepare for a larger trial.
At a glance
What is this study about?
When people are treated for head and neck cancer, they often need an operation called a neck dissection to remove lymph nodes. A nerve called the spinal accessory nerve passes right through this area. This nerve controls the muscles that help you shrug, lift your arm, and move your shoulder. Even when surgeons are very careful, the nerve can get stretched or irritated during surgery. This can leave people with shoulder pain, stiffness, and arm weakness that lasts for months, making everyday tasks like dressing or driving difficult.
Early research shows that applying a mild electrical pulse directly to an injured nerve during an operation might help it repair itself faster. While past tests looked at 60 minutes of stimulation, that adds a lot of time to surgery. Scientists believe a shorter, 10-minute burst might work just as well and fit much better into normal hospital schedules.
Before launching a massive clinical trial across the country, researchers need to run this small 'pilot' study at the Churchill Hospital in Oxford. Its main purpose is to test whether patients are happy to take part, whether the surgical team can easily fit the 10 minutes of stimulation into the operation, and how smoothly the follow-up tests run. The findings will help doctors design the best possible large-scale study in the future.
Key takeaways
- Tests whether a 10-minute nerve stimulation during neck surgery is practical to run in the NHS.
- Aims to protect a key shoulder nerve from lasting weakness and pain caused by surgery.
- Involves 14 adult patients having curative head and neck cancer surgery at Churchill Hospital in Oxford.
- Participants are randomly assigned to either standard surgery or surgery with 10 minutes of stimulation.
- Follow-up checks take place at 3, 6, and 12 months, usually alongside routine hospital visits.
Who may be eligible?
This study is open to adults aged 18 and over who have been diagnosed with head and neck cancer and are already scheduled for a neck dissection aimed at curing their cancer. To take part, you must be able to understand the study details and give your own consent.
You will not be able to join if you have already had neck surgery in the past, or if you already live with nerve problems or shoulder disability. People with implanted electrical devices, such as pacemakers, cannot take part for safety reasons. You will also not be included if your surgeon already knows they will need to cut away the shoulder nerve or muscle to clear the cancer.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged 18 or older.
- I have head and neck cancer and am booked for a neck dissection.
- I have not had surgery on this part of my neck before.
- I do not have a pacemaker or other implanted electrical device.
- I do not have existing shoulder disability or nerve conditions.
What does participation involve?
If you take part, you will be placed into one of two groups by chance (randomly). One group receives standard NHS surgery. The other group receives standard surgery plus 10 minutes of mild nerve stimulation while asleep under general anaesthetic. You will not be told which group you are in so that test results remain fair and unbiased.
Before your operation, you will fill out questionnaires about your shoulder and quality of life, have basic movement tests, and give a blood sample. After surgery, you will have follow-up visits at 3, 6, and 12 months. At each visit, doctors will re-check your shoulder movement and nerve recovery. These visits will be timed to match your regular cancer check-ups whenever possible. In total, you will be involved for about 15 months from your first screening call.
Potential risks and benefits
Locations (1)
- Oxford University Hospitals NHS Foundation TrustCity onlyOxford, England
Common questions
Will the electrical stimulation hurt?
No. The stimulation is given only while you are completely asleep under general anaesthetic during your operation, so you will not feel it.
Will taking part delay my cancer surgery?
No. Your operation will happen as planned on your normal NHS schedule. The trial only adds about 10 minutes to the time you are asleep in the operating theatre.
Can I choose to have the nerve stimulation?
No. A computer puts participants into groups at random to make sure the comparison is fair. Neither you nor your research team can choose your group.
Do I have to travel for extra hospital visits?
Researchers will try to arrange your 3, 6, and 12-month study check-ups on the same days as your regular follow-up appointments to save you extra trips.
What happens if I change my mind later?
You can leave the study at any time without giving a reason. Your standard NHS cancer care and support will carry on exactly as normal.
How to find out more
Akira Wiberg
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
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