Abstract
Need for neck dissection begins with thorough evaluation, including fine needle aspiration and possibly excisional lymph node biopsy. The incidence of the various neck metastases are provided, including those for cutaneous squamous cell carcinoma; salivary gland neoplasms; cervical lymph node metastases; squamous cell carcinoma of the upper aerodigestive tract; and metastatic well-differentiated thyroid cancer. Staging of neck cancer is also defined. Indications and contraindications for neck dissection are provided. Operative planning begins with the decision on the choice of procedure: a comprehensive dissection that will result in a radical or modified neck dissection; a selective neck dissection; an extended neck dissection; or a bilateral neck dissection. Neck dissection after chemoradiation is also discussed. Reconstruction after resection of large tumors with large margins is also described, along with current evidence relating to preservation of vascular structures and subsequent predisposition to recurrence. The operative steps for radical, modified, and selective neck dissection are described. Both intraoperative and postoperation complications are explained. This review contains 5 figures, 1 table, and 51 references.
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