The purpose was to effectvely remove all of the lymph nodes present in the neck and their interconnecting lymphatics. The radical neck dissection was first described in 1906 by Crile, based on the Halstedian concept of en bloc resection.The selection of which levels of lymph nodes require removal depends on the location of the primary tumor and the predicted spread of local disease to regional sites (see Table IIIE-1 PDF).Evidence of extracapsular spread by clinical or radiographic evaluation (ie, fixed nodes, involvement of deep neck muscles, cranial nerves, sternocleidomastoid muscle, internal jugular vein, carotid artery (would require more radical dissection than a 'selective neck dissection'.Recent reports have further decreased the extent of selective neck dissections to include 'nidusectomy' or removal of only the abnormal metastastic residual after chemo-radiotherapy.When indicated, application of postoperative radiation therapy reduces the rate of regional failure. In selected groups of patients with N+ disease, the use of SND is gaining support.Serves as a staging procedure and can be used for decision making regarding the need for adjuvant postoperative radiation therapy.See Table IIIE-1 ( PDF) and Cervical Lymphadenectomy- General Considerations protocol of selected N1 neck dissection Elective treatment of N0 neck with significant risk of regional metastasis.See also: Myositis Ossificans of the Neck Surgical Treatment Heterotopic Bone Formation After Trauma Marginal Mandibular Nerve Weakness (Ramus Mandibularis) Level I Neck Dissection (extended) recurrent pleomorphic adenoma
See also: Thoracic Duct and Chylothorax: General Considerations Return to: Cervical Lymphadenectomy- General Considerations
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