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Modified Radical Neck Dissection

  • Cord SturgeonEmail author
  • Dina M. Elaraj
Chapter

Abstract

All patients with a diagnosis of thyroid cancer should have a complete preoperative ultrasound of the central and lateral compartments of the neck, with a clear documentation of the description and location of suspicious lymph nodes using the standard nomenclature. Fine needle aspiration biopsy of suspicious lymph nodes should be performed preoperatively in order to guide the extent of surgery. Papillary and medullary thyroid cancers frequently metastasize to the cervical lymph nodes. Thyroid cancer nodal metastases are best treated with formal compartmental clearance. For metastatic thyroid cancer within the lateral neck, the authors perform a formal nodal clearance of levels IIA, III, IV, and VB. The standard nomenclature, preoperative preparation, steps of the dissection, and postoperative care are described.

Keywords

Neck dissection metastatic thyroid cancer surgical technique 

References

  1. 1.
    Shah JP, Strong E, Spiro RH, Vikram B. Neck dissection – current status and future possibilities. Clin Bull. 1981;11(1):25–33.PubMedGoogle Scholar
  2. 2.
    Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Official report of the academy’s committee for head and neck surgery and oncology. Arch Otolaryngol Head Neck Surg. 1991;117(6):601–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A, et al. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2002;128(7):751–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, et al. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008;134(5):536–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Bocca E, Pignataro O. A conservation technique in radical neck dissection. Ann Otol Rhinol Laryngol. 1967;76(5):975–87.CrossRefPubMedGoogle Scholar
  6. 6.
    Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16(2):109–42.CrossRefPubMedGoogle Scholar
  7. 7.
    Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.CrossRefPubMedGoogle Scholar
  8. 8.
    Tuttle RM, Ball DW, Byrd D, Dilawari RA, Doherty GM, Duh QY, et al. Thyroid carcinoma. J Natl Compr Canc Netw. 2010;8(11):1228–74.PubMedGoogle Scholar
  9. 9.
    Moley JF, DeBenedetti MK. Patterns of nodal metastases in palpable medullary thyroid carcinoma: recommendations for extent of node dissection. Ann Surg. 1999;229(6):880–7; discussion 7–8.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Evans DB, Shapiro SE, Cote GJ. Invited commentary: medullary thyroid cancer: the importance of RET testing. Surgery. 2007;141(1):96–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Tuttle RM, Ball DW, Byrd D, Daniels GH, Dilawari RA, Doherty GM, et al. Medullary carcinoma. J Natl Compr Canc Netw. 2010;8(5):512–30.PubMedGoogle Scholar
  12. 12.
    Brandi ML, Gagel RF, Angeli A, Bilezikian JP, Beck-Peccoz P, Bordi C, et al. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab. 2001;86(12):5658–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009;19(6):565–612.CrossRefPubMedGoogle Scholar
  14. 14.
    Uchino S, Noguchi S, Yamashita H, Watanabe S. Modified radical neck dissection for differentiated thyroid cancer: operative technique. World J Surg. 2004;28(12):1199–203.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Surgery, Section of Endocrine SurgeryNorthwestern University Feinberg School of MedicineChicagoUSA

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