Try reloading this page, or reviewing your browser settings
This segment describes the dissection of levels II and III.
- Head and neck cancer
- Supraomohyoid neck dissection
- Nodal metastasis
- Oral squamous cell cancer
- Cervical lymph nodes
- Level II
- Level III
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.Robbins KT (2000) Indications for selective neck dissection: when, how, and why. Oncology (Williston Park) 14(10):1455–1464Google Scholar
- 4.Grénman R (2010) Principles and techniques of neck dissection. In: Anniko M, Bernal-Sprekelsen M, Bonkowsky V, Bradley P, Iurato S (eds) Otorhinolaryngology, head and neck surgery. European manual of medicine. Springer, BerlinGoogle Scholar
About this video
- Krishnakumar Thankappan
- First online
- 02 March 2019
- Online ISBN
- Springer, Cham
- Copyright information
- © The Author(s) 2019
Attention is now to elevate the lower skin flap subplatysmally, the lower limit of which is the superior belly of the omohyoid muscle. This lower skin flap is retracted with the help of a skin stitch. The external jugular vein and the retromandibular vein is being dissected and preserved.
The level IIA nodal tissue is seen being dissected off. The spinal accessory nerve is seen being exposed and preserved. The fibrofatty tissue, posterior-superior to the spinal accessory we nerve– that’s the level IIB– is dissected of carefully, without much traction on the nerve.
The superior belly of omohyoid is being delineated, which is the lower limit of dissection. Level IIA tissue is further being dissected. Posteriorly, the dissection is over the plane of the branches of the deep cervical plexus. These branches can be preserved. The dissection is seen here over the deep cervical plexus.
The next step is the sharp dissection with a 15-number surgical blade to separate the tissue of the internal jugular vein. It’s very important to preserve the anterior tributaries of the internal jugular vein.
The specimen is finally being separated off, and that finishes the level II and III neck dissection. The anatomical structures are being demonstrated– the spinal accessory nerve, the internal jugular vein, the anterior tributaries, the deep cervical plexus, and the superior thyroid artery.
The procedure is completed, and the wound closed in layers. A suction drain was kept for drainage.
To summarize, selective neck dissection is done in early-stage oral cancer. It is an elective prophylactic surgical procedure done along with the primary dissection. The video demonstrated the removal of neck nodal levels I, II, and III. Thank you.