What is a radical neck dissection? when is it done?

What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

How can I get to a surgical consultant? What does a surgical consultant do?

The majority of patients have already been seen by their own physician or a previous nonsurgical consultant. They are referred to a specific surgeon for any number of reasons, the most important being that he is regarded as especially capable in the area of a particular problem. Physicians tend to refer patients to surgeons in their own hospital so that they may also participate in the subsequent handling of the case. Other patients may prefer to choose the surgeon themselves because of his reputation or because he has already treated a member of the family or an acquaintance. A surgeon may also be selected by a referral from a specific agency, a medical group or union panel, or a hospital administration office. Another patient may choose to go to a particular hospital or clinic and leave the choice of a surgeon to that organization's administrative policy.

What makes one a surgeon?

A surgeon is, first of all, a physician. He is a M(edical) D(octor). After receiving his degree, he has spent sufficient time in hospital training in surgery (four to seven years) to qualify for and satisfactorily pass an examination which enables him to be recognized as a specialist.

A surgeon maintains an ongoing relationship within a hospital, medical school or clinic where his activities comprise the total care of surgical patients and the training of others in surgery.

What qualifies a doctor as a surgeon and surgical consultant?

A physician is recognized as qualified in surgery if he is a Fellow of the American College of Surgeons (FACS), a diplomate of the American Board of Surgery, or both. Eminence in a particular area of surgery is usually based on scientific publications and position within a hospital, medical school or clinic.

What actually takes place at the consultation?

The surgeon will ask the patient about his symptoms in great detail. He elicits a complete history of pertinent medical facts. The patient will then have a general physical examination, with specific emphasis on his problem.If the patient has X rays or laboratory tests available, these are reviewed.

On the basis of history, examination, laboratory and X ray reports the surgeon will present his opinion about what should be done. The choices include still further diagnostic tests, different or additional X rays, admission to the hospital for treatment or for further studies. The surgeon may decide to reevaluate the problem after a specific time interval, discover that there is no surgical problem or that no surgical care is presently required.

You may then ask whatever pertinent question you like. It is preferable to appear the fool by asking the question than to remain the ostrich in ignorance. Sometimes the disturbingly pertinent question is not asked because the patient fears the answer.


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