2005 Volume 17 Issue 4 Pages 217-231
Cervical node metastasis, the most serious prognostic factor in patients with oral carcinoma, remains a challenge to oral surgeons. Radical neck dissection, as systematized by Crile and popularized by Martin et al, was the only surgical treatment available for a long time.
However, considering the functonal and esthetic, damage (outcome) following classical radical neck dissection and its effect on qality of life, new methods of neck dissection such as modified radical neck dissection and selective neck dissection have recently been developed.
Modified radical neck dissection is an attractive approach as it preserves the spinal accsessory nerve, internal jugular vein, and stemocleidomastoid muscle. On the other hand, selective neck dissection is a procedure to remove only node groups at greatest risk for metastasis. The type of neck dissection used varies with tumor stage.
Topographic distribution of lymph node metastasis differs between oral cancer and cancers of the pharynx and larynx. Hence, the procedure of neck dissection for metastasis of oral cancer is somewhat specific. I would like to illustrate three neck dissection procedures, classical radical neck dissection, modified radical neck dissection, and supraomohyoid neck dissection for oral cancer.
