Neck dissection: nomenclature, classification, and technique.
Lymph node status is the single most important prognostic factor in head and neck cancer because lymph node involvement decreases overall survival by 50%. Appropriate management of the regional lymphatics, therefore, plays a central role in the treatment of the head and neck cancer patients. Performing an appropriate neck dissection results in minimal morbidity to the patient, provides invaluable data to accurately stage the patient, and guides the need for further therapy. The purposes of this article are to present the history and evolution of neck dissections, including an update on the current state of nomenclature and current neck dissection classification, describe the technique of the most common neck dissection applicable to oral cavity cancers, and discuss some of the complications associated with neck dissection. Finally, a brief review of sentinel lymph node biopsy will be presented.
Holmes
Jon D
JD
Oral and Facial Surgery of Alabama, 1500 19th Street South, Birmingham, AL 35205, USA. j-holmes@mindspring.com
D006470:Hemorrhage / Q000209:etiology; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery*; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000473:pathology*; D009333:Neck / Q000601:surgery*; D037981:Neck Dissection / Q000145:classification* / Q000266:history / Q000379:methods*; D059348:Peripheral Nerve Injuries; D021701:Sentinel Lymph Node Biopsy; D009626:Terminology as Topic