To understand the current status, international cooperation, research hotspots, and development trends of nutritional studies on patients with head and neck cancer from 2014 to 2024, and to predict future research trends.

The Web of Science Core Collection database was searched to retrieve nutritional studies on patients with head and neck cancer from January 2014 to March 2024. The type of studies were “articles,” the language was English, CiteSpace 6.1 R6 software was used to conduct the bibliometric analysis, and the results were visualized to form a scientific knowledge map.

A total of 1528 documents were retrieved, with a linear increase in the number of annual publications. The country with the highest number of publications was the United States, and the institution with the highest number of publications was the University of Queensland, with closer collaboration between authors and institutions. The most frequently cited publication was a set of nutrition guidelines, and the highest-impact articles were mainly concerned with performing percutaneous endoscopic gastrostomy. Keyword analysis showed that quality of life, radiotherapy, and weight loss were the keywords of highest interest. The keyword cluster analysis resulted in 17 clusters, which were divided into five main categories: head and neck cancer, treatment, outcome results, intervention modalities, and rehabilitation. Body composition, enteral nutrition, and accelerated postoperative rehabilitation were persistent research hotspots. Keyword highlighting revealed that “enhanced recovery after surgery” has been the focus of research in the last two years, with “index” and “model” emerging as theme words.

The number of publications in the literature related to nutrition for patients with head and neck cancer has increased annually over the past 10 years. The research hotspots mainly focus on the quality of life and weight loss during radiotherapy, the content and application prospect of body composition assessment, different modes of nutritional support interventions and enteral nutritional tube feeding routes, and perioperative nutritional management in enhanced recovery after surgery. The potential clinical value of preoperative nutritional intervention under the concept of enhanced recovery and the construction of new types of nutritional index are the trends of future research.

To explore the effect of a phased rehabilitation training programme to relieve shoulder dysfunction in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recovery of patients.

This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion, and 70 eligible patients from Hospital of Stomatology, Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group (35 patients in each group). The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery, such as shoulder mobility and coordination training and small range of motion training of the neck, while the test group took part in a rehabilitation training program that included familiarization maneuver training, protective rehabilitation, exercise rehabilitation, and resistance training in the following four stages: preoperative, postoperative general anesthesia and awake until the removal of stitches, the removal of stitches until 6 weeks after surgery, and 6 weeks after surgery until 1 year after surgery. The frequency of training in both groups was at least 3 days per week, and the length of each training session was 10-15 min. The intensity of exercise was 2-3 points on the Borg Conscious Exercise Intensity Scale (i.e., mild-to-moderate tachypnea or fatigue). The neck dissection injury index (NDII) was used to evaluate the quality of life related to shoulder joint function at four time points: preoperative, postoperative 3 months, postoperative 6 months, and postoperative 12 months. The higher the score, the better the quality of life.

28 cases in the test group and 32 cases in the control group completed a one-year follow-up. At 3 and 6 months postoperative, the NDII of the test group was significantly higher than that of the control group [3 months postoperative: test group (93.48 ± 9.36) vs. control group (80.00 ± 11.34) (P<0.001), 6 months postoperative: test group (98.21 ± 4.76) vs. control group (90.70 ± 9.12) (P<0.001)]; 12 months after surgery, the NDII of the test group (97.23 ± 4.88) was still higher than that of the control group (96.33 ± 4.49), but the difference was not statistically significant (P = 0.458). The difference in NDII scores among subjects at 3, 6, and 12 months after surgery was statistically significant in each group (P<0.001).

The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients' shoulder joint function within 6 months after surgery.