1. Neck dissection involves removing lymph nodes from different levels in the neck to stage and treat head and neck cancers.
2. The extent of neck dissection, such as radical or modified radical, depends on how many non-lymphatic structures like the spinal accessory nerve are preserved.
3. Selective neck dissections remove nodes from only certain levels, while comprehensive dissections are used to treat cancer that has spread to lymph nodes.
4. Emil Theodor Kocher Earned Nobel Prize in 1909 for his work in thyroid and neck surgery — the first ever awarded to a surgeon. 1880 – Kocher proposed removing nodal metastases
5. 1906 – George Crile described the classic radical neck dissection (RND)
6. 1967 - Bocca and Pignataro described the “functional neck dissection” (FND)
19. Level VA & VB Nasopharynx, oropharynx, posterior scalp/neck skin
20. Level VI Thyroid gland, glottic and subglotticlarynx, apex of piriform sinus, cervical esophagus
21. “N” classification – AJCC (1997) Consistent for all mucosal sites except the nasopharynx Staging of the neck Thyroid and nasopharynx have different staging based on tumor behavior and prognosis
22. Single ipsilateral lymph node 3 to 6 cm Single ipsilateral lymph node, < 3 cm No regional lymph node metastases Multiple ipsilateral lymph nodes < 6 cm Bilateral or contralateral nodes < 6cm Metastases > 6 cm Lymph node staging
33. T3 or T4 Oral cavity tumors and tumor thickness (>3 mm) supraomohyoidneck dissection. Increasing stage of the oropharynx, hypopharynx, and supraglottic larynx needs lateral neck dissection. Algorithm for treating an N0