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Evolution of Neck Dissection for Improved Functional Outcome

  • World Progress in Surgery
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Abstract

Neck dissection plays a crucial role in the management of metastatic neck disease. Until recently, radical neck dissection has been the standard treatment for malignant cervical adenopathy irrespective of the nodal staging. However, in recent years, there has been a trend toward the development of more conservative operations, wherein certain nonlymphatic structures and lymph node groups can be selectively preserved. Radical neck dissection still remains the surgical standard against which various modifications must be compared. The need to perform more conservative surgery comes from the realization that the radical operation is attended by significant postoperative morbidity, and that some of the structures removed in the course of this operation can actually be preserved without any compromise in oncologic safety. The purpose of this article is to discuss the evolution of conservation surgery in the management of metastatic neck disease, define the clinical applications of various types of neck dissection, and evaluate the implications of these conservation approaches on preservation of function.

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References

  1. GH Fletcher (1972) ArticleTitleElective irradiation of subclinical disease in cancers of the head and neck Cancer 29 1450–1454 Occurrence Handle1:STN:280:CS2B3c7hs1I%3D Occurrence Handle5031239

    CAS  PubMed  Google Scholar 

  2. UP Fisch ME Sigel (1964) ArticleTitleCervical lymphatic system as visualized by lymphography Ann. Otol. Rhinol. Laryngol. 73 870–882 Occurrence Handle1:STN:280:CCqD2czpsFY%3D

    CAS  Google Scholar 

  3. JP Shah (1990) ArticleTitlePatterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract Am. J. Surg. 160 405–409 Occurrence Handle1:STN:280:By6D38zivFc%3D Occurrence Handle2221244

    CAS  PubMed  Google Scholar 

  4. KT Robbins JE Medina GT Wolfe et al. (1991) ArticleTitleStandardizing neck dissection terminology. Official report of the Academy’s Committee for Head and Neck Surgery and Oncology Arch. Otolaryngol. Head Neck Surg. 117 601–605 Occurrence Handle1:STN:280:By6B2c3gs1E%3D Occurrence Handle2036180

    CAS  PubMed  Google Scholar 

  5. KT Robbins (1998) ArticleTitleClassification of neck dissection: current concepts and future considerations Otolaryngol. Clin. North Am. 31 639–655 Occurrence Handle1:STN:280:DyaK1czlt1agsA%3D%3D Occurrence Handle9687326

    CAS  PubMed  Google Scholar 

  6. EM Jr Diaz JR Austin LI Burke et al. (1996) ArticleTitleThe posterolateral neck dissection. Technique and results Arch. Otolaryngol. Head Neck Surg. 122 477–480 Occurrence Handle8615963

    PubMed  Google Scholar 

  7. E Bocca O Pignataro (1967) ArticleTitleA conservation technique in radical neck dissection Ann. Otol. Rhinol. Laryngol. 76 975–987 Occurrence Handle1:STN:280:CCeD1MznslY%3D Occurrence Handle6074244

    CAS  PubMed  Google Scholar 

  8. RE Lingeman C Helmus R Stephens et al. (1977) ArticleTitleNeck dissection: radical or conservative Ann. Otol. Rhinol. Laryngol. 86 737–744 Occurrence Handle1:STN:280:CSeD2sbgsFc%3D Occurrence Handle596770

    CAS  PubMed  Google Scholar 

  9. E Bocca O Pignataro C Oldini et al. (1984) ArticleTitleFunctional neck dissection: an evaluation and review of 843 cases Laryngoscope 94 942–945 Occurrence Handle1:STN:280:BiuB2cvpsVw%3D Occurrence Handle6738274

    CAS  PubMed  Google Scholar 

  10. RH Jesse AJ Ballantyne D Larson (1978) ArticleTitleRadical or modified neck dissection: a therapeutic dilemma Am. J. Surg. 136 516–519 Occurrence Handle1:STN:280:CSaD3sbntFU%3D Occurrence Handle707734

    CAS  PubMed  Google Scholar 

  11. RH Spiro GJ Morgan EW Strong et al. (1996) ArticleTitleSupraomohyoid neck dissection Am. J. Surg. 172 650–653 Occurrence Handle10.1016/S0002-9610(96)00300-5 Occurrence Handle1:STN:280:ByiC2c3msVM%3D Occurrence Handle8988669

    Article  CAS  PubMed  Google Scholar 

  12. DH Henick CE Silver KS Heller et al. (1995) ArticleTitleSupraomohyoid neck dissection as a staging procedure for squamous cell carcinomas of the oral cavity and oropharynx Head Neck 17 119–123 Occurrence Handle1:STN:280:BymD3M3ktFc%3D Occurrence Handle7558808

    CAS  PubMed  Google Scholar 

  13. R Lindberg (1972) ArticleTitleDistribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts Cancer 29 1446–1449 Occurrence Handle1:STN:280:CS2B3c7hs1E%3D Occurrence Handle5031238

    CAS  PubMed  Google Scholar 

  14. KT Pitman JT Johnson EN Myers (1997) ArticleTitleEffectiveness of selective neck dissection for management of the clinically negative neck Arch. Otolaryngol. Head Neck Surg. 123 917–922 Occurrence Handle1:STN:280:ByiH2M%2FisFY%3D Occurrence Handle9305240

    CAS  PubMed  Google Scholar 

  15. YP Talmi HT Hoffman Z Horowitz et al. (1998) ArticleTitlePatterns of metastases to the upper jugular lymph nodes (the “submuscular recess”) Head Neck 20 682–686 Occurrence Handle10.1002/(SICI)1097-0347(199812)20:8<682::AID-HED4>3.0.CO;2-J Occurrence Handle1:STN:280:DyaK1M%2FgsV2nug%3D%3D Occurrence Handle9790288

    Article  CAS  PubMed  Google Scholar 

  16. RM Byers RS Weber T Andrews et al. (1997) ArticleTitleFrequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue Head Neck 19 14–19 Occurrence Handle1:STN:280:ByiC1c3otVQ%3D Occurrence Handle9030939

    CAS  PubMed  Google Scholar 

  17. JE Medina RM Byers (1989) ArticleTitleSupraomohyoid neck dissection: rationale, indications, and surgical technique Head Neck 11 111–122 Occurrence Handle1:STN:280:BiaB2Mvks1M%3D Occurrence Handle2722487

    CAS  PubMed  Google Scholar 

  18. EW Strong (1969) ArticleTitlePreoperative radiation and radical neck dissection Surg. Clin. North Am. 49 271–276 Occurrence Handle1:STN:280:CCaC3sfgtlQ%3D Occurrence Handle5774982

    CAS  PubMed  Google Scholar 

  19. RM Byers GL Clayman D McGill et al. (1999) ArticleTitleSelective neck dissection for squamous carcinoma of the upper aerodigestive tract: patterns of regional failure Head Neck 21 499–505 Occurrence Handle10.1002/(SICI)1097-0347(199909)21:6<499::AID-HED1>3.3.CO;2-1 Occurrence Handle1:STN:280:DyaK1MzotVajsw%3D%3D Occurrence Handle10449664

    Article  CAS  PubMed  Google Scholar 

  20. PK Pellitteri KT Robbins T Neuman (1997) ArticleTitleExpanded application of selective neck dissection with regard to nodal status Head Neck 19 260–265 Occurrence Handle10.1002/(SICI)1097-0347(199707)19:4<260::AID-HED3>3.0.CO;2-Z Occurrence Handle1:STN:280:ByiA2Mnms1M%3D Occurrence Handle9213103

    Article  CAS  PubMed  Google Scholar 

  21. SJ Traynor JI Cohen J Gray et al. (1996) ArticleTitleSelective neck dissection and the management of the node-positive neck Am. J. Surg. 172 654–657 Occurrence Handle10.1016/S0002-9610(96)00296-6 Occurrence Handle1:STN:280:ByiC2c3msVw%3D Occurrence Handle8988670

    Article  CAS  PubMed  Google Scholar 

  22. PE Andersen JP Shah E Cambronero et al. (1994) ArticleTitleThe role of comprehensive neck dissection with preservation of the spinal accessory nerve in the clinically positive neck Am. J. Surg. 168 499–502 Occurrence Handle1:STN:280:ByqD28fmt1M%3D Occurrence Handle7977984

    CAS  PubMed  Google Scholar 

  23. SO Short JN Kaplan GE Laramore et al. (1984) ArticleTitleShoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve Am. J. Surg. 148 478–482 Occurrence Handle1:STN:280:BiqD38%2Fkslc%3D Occurrence Handle6486316

    CAS  PubMed  Google Scholar 

  24. S Sobol C Jensen WD Sawyer et al. (1985) ArticleTitleObjective comparison of physical dysfunction after neck dissection Am. J. Surg. 150 503–509 Occurrence Handle1:STN:280:BimD38zjvFY%3D Occurrence Handle4051117

    CAS  PubMed  Google Scholar 

  25. JR Saunders SuffixJr RM Hirata DA Jaques (1985) ArticleTitleConsidering the spinal accessory nerve in head and neck surgery Am. J. Surg. 150 491–494 Occurrence Handle4051114

    PubMed  Google Scholar 

  26. B Leipzig JY Suen JL English et al. (1983) ArticleTitleFunctional evaluation of the spinal accessory nerve after neck dissection Am. J. Surg. 146 526–530 Occurrence Handle1:STN:280:BiuD387mtVY%3D Occurrence Handle6625099

    CAS  PubMed  Google Scholar 

  27. D Remmler R Byers J Scheetz et al. (1986) ArticleTitleA prospective study of shoulder disability resulting from radical and modified neck dissections Head Neck Surg. 8 280–286 Occurrence Handle1:STN:280:BimA3czmtVU%3D Occurrence Handle3744856

    CAS  PubMed  Google Scholar 

  28. EC Weisberger J Kincaid J Riteris (1998) ArticleTitleCable grafting of the spinal accessory nerve after radical neck dissection Arch. Otolaryngol. Head Neck Surg. 124 377–380 Occurrence Handle1:STN:280:DyaK1c3hvVGrtw%3D%3D Occurrence Handle9559683

    CAS  PubMed  Google Scholar 

  29. KC Soo RJ Guiloff A Oh et al. (1990) ArticleTitleInnervation of the trapezius muscle: a study in patients undergoing neck dissections Head Neck 12 488–495 Occurrence Handle1:STN:280:By6D2sfptlM%3D Occurrence Handle2258287

    CAS  PubMed  Google Scholar 

  30. KC Soo EW Strong RH Spiro et al. (1993) ArticleTitleInnervation of the trapezius muscle by the intra-operative measurement of motor action potentials Head Neck 15 216–221 Occurrence Handle1:STN:280:ByyB2MbnvVU%3D Occurrence Handle8491585

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology–Head and Neck Surgery, University of Tennessee, Memphis, 956 Court Avenue, B222, Memphis, Tennessee 38163, USA

    Sandeep Samant M.S.

  2. Division of Otolaryngology, Southern Illinois University, P.O. Box 19638, Springfield, Illinois 62794-9638, USA

    K. Thomas Robbins M.D.

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  1. Sandeep Samant M.S.
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  2. K. Thomas Robbins M.D.
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Correspondence to Sandeep Samant M.S..

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Samant, S., Robbins, K. Evolution of Neck Dissection for Improved Functional Outcome. World J. Surg. 27, 805–810 (2003). https://doi.org/10.1007/s00268-003-7113-6

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