| Abstract: |
Radical neck dissection was historically the standard of care for the management of cervical nodal metastases. A radical neck dissection includes the complete resection of all five levels of the cervical lymphatics, and additionally sacrifice of the spinal accessory nerve, sternocleidomastoid and the internal jugular vein. This procedure causes considerable morbidity, predominantly from shoulder dysfunction, and numerous studies have since demonstrated that the surgical preservation of non-invaded structures was oncologically sound. More recent modifications of neck dissection are now performed that selectively remove the lymph nodes in the anatomic levels that are at highest risk for harboring metastatic nodal disease while preserving key structures, and carry much less morbidity. The following chapter addresses the history, techniques, morbidity, post-operative considerations, and potential complications of a radical neck dissection. |
