ADVANCES IN THE MANAGEMENT OF NECK DISSECTION: A REVIEW
The proper management of neck in patients with head and neck malignancies is one of the unresolved oncologic questions. Cervical metastasis is one of the major risk factor and the best prognostic indicators for patient with head and neck cancer. Patients who present with tumors localized at the primary site without dissemination to regional lymph node enjoy an excellent prognosis and can be cured by appropriate use of surgery, radiotherapy or both. On the other hand once dissemination to regional lymph nodes takes place, the probability of 5 years survival, regardless of treatment, reduces to nearly one half of that seen in early staged patients. The purpose of this article is to study the current concepts in cervical lymph node metastases and development of various techniques in neck dissection to reduce morbidity while eradicating the pathology completely.
2. Lloyd M. Nyhus, Robert Baker: Master of Surgery. Second edition: volume 1: 168-177.
3. Schwartz, Shires spencer (fifth edition): Principles of Surgery: 581-622.
4. Moore Oliver S: Bilateral neck dissection: Surgical Clinics of North America 1969; 49 No.2: 277-283.
5. Rouvier H: Anatomy of the Human Lymphatics System. Ann Arbor, Mich, Edwards Brother 1938.
6. J. P. Shah et al: Cervical lymph node metastasis: Curr Probl Surg 1993; 284- 335.
7. Michael. T. Madison, Kent. B. Remley et al: Radiologic diagnosis and staging of Head and Neck Squamous Cell Carcinoma: Otolaryngologic Clinic of North America 1998; 31 No. 4:727-754.
8. Jatin P Shah, Frank C. Candela, and Anil K. Poddar: The patterns of cervical lymph node metastases from Squamous Carcinoma of the oral cavity. Cancer 1990; 66: 109-113.
9. Guy J. Petruzzelli, Janette Benefield and Sheri Yong: Mechanism of Lymph node metastases: Current Concept. Otolaryngologic clinics of NA. 1998; 31 No. 4: 585-599.
10. Nakayama Eiji, Ariji Eiichire, Shinohara Masanori, Yoshiura Kazunori, Miwa Kunihiro, Kanda Shiginobu: CT appearance of marked keratinization of metastatic cervical lymph nodes: Journal of Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 1997; 84: 321-6
11. Cavalcanti GP, Vannier MW: The role of 3-D spiral CT in oral metastases: Journal of Dentomaxillofacial Radiology 1998; 27: 203-8
12. Yuasa K, Kawazu T, Nagata T, Kanda S, Ohishi M, Shirasuna K: Computed Tomography and Ultrasonography of metastatic cervical lymph nodes in oral squamous cell carcinoma: Journal of Dentaomaxillofacial Radiology 2000; 29: 238-44
13. Gagliardi G, Bayar S, Smith R, Salem RR. Preoperative staging of rectal cancer using magnetic resonance imaging with external phase-arrayed coils. Arch Surg.
2002; 137: 447-451.
14. Fischbein NJ, Noworolski SM, Henry RG, Kaplan MJ, Dillon WP, Nelson SJ. Assessment of metastatic cervical adenopathy using dynamic contrastenhanced MR imaging. AJNR.2003; 24: 301-311.
15. Kademani and Dierks: A straight incision for neck dissection: Technical note. Journal oral maxillofacial surg. 2005; 63: 563-565.