The use and misuse of neck dissection for head and neck cancer

Abstract

Management of the Carotid Artery in Neck Dissection Neck dissection, or cervical lymphadenectomy, is a time-honored procedure used to treat metastastic carcinoma to the neck. Under most circumstances, the site of origin lies within the upper aerodigestive tract, thyroid gland, salivary glands, or the surrounding cutaneous structures. Contemporary approaches to neck surgery have included modifications of the classical radical neck dissection involving preservation of certain lymphatic regions, sparing nonlymphatic structures, or in some situations, removal of additional structures. As other modalities are proving to be effective treatment strategies for metastatic neck cancer, there is also a pressing need to define the role of neck dissection as part of a multimodality approach. Given this evolving role of neck dissection, this article is intended to outline the use and, in some situations, the misuse of these procedures in the management of patients with head and neck carcinoma. We served as panelists when this topic was presented at the annual meeting of the American College of Surgeons, October 2000.