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Radical Neck Dissection

Radical Neck Dissection

Definition

A radical neck dissection is a procedure used to remove cancerous tumors from one side of the neck or upper airway. Almost all the lymph nodes and some of the muscles, tissues, veins, and nerves in this area are removed as well.

Who is a candidate for the procedure?

A person who has a cancerous tumor in the lymph nodes in the neck and upper airway is a candidate for this procedure.

How is the procedure performed?

The procedure is done under general anesthesia. This means that the person will be put to sleep with medications. An incision, or cut, is made under the chin towards the ear. Another incision is made at the bottom of the neck. A third incision is made down the middle of the neck. These three cuts form the shape of a sideways "H." Other incisions may also be made so the surgeon has a full view of the structures inside the neck. The skin is then spread open and the tissues underneath the skin are pulled away from the skin. The surgeon then removes the lymph glands from the neck and oral cavity.
In addition to the lymph nodes, there are three main structures that are removed from the neck area. These are:
  • the internal jugular vein
  • the accessory nerve
  • the sternocleidomastoid muscle
Any other veins, nerves, or muscles that are involved with the cancer are also removed. If the cancer has spread, it may be necessary to remove sections of the jaw and tongue. At times, it is also necessary to perform a tracheostomy. A tracheostomy is a surgically created opening through the neck into the trachea, or windpipe. The incision is closed with sutures, staples, or skin clips.

Sources

Harrison's Principles of Internal Medicine, Fauci et al, 1998

Complete Guide to Symptoms, Illness&Surgery, H. Griffith, M.D, 2000

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