Neck dissection
Definitions:
[edit | edit source]- Central neck dissection (level VI +/- VII): removal of all lymph node tissue en bloc in the compartment bounded by the hyoid bone superiorly, innominate vein inferiorly, carotid sheaths laterally, and anterior to to the trachea, RLNs, and deepest layer of cervical fascia
- Radical dissection: I-V, taking SCM, spinal accessory nerve and IJV
- Modified radical: leaving one or more of SCM, spinal accessory nerve and IVJ
- Lateral: II-V
Modified radical technique
[edit | edit source]- Extended collar incision, providing access to tragus
- Sub-platysmal flaps
- Identify EJV and follow to greater auricular nerve, then also find spinal accessory nerve
- Skeletonise anterior SCM to identify carotid sheath, including omohyoid ligation
- Level V compartment mobilised from lateral to medial
- Also need to take levels 2, 3, 6