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.

Does type 2 diabetes cause high blood pressure?

Why is diabetes on the list of risk factors?

Almost 9 million Americans now have diabetes, and there are more than 600,000 new cases every year. About 89,000 Americans died from diabetes in 2000.

The most common type of diabetes, and the kind you can do something about, is called adult-onset or Type 2 diabetes. It usually develops in adulthood, usually doesn’t require insulin for its treatment, and is diagnosed when your morning blood sugar is over about 120 mg/dl. Being overweight is one of the major predisposing factors of Type 2 diabetes. Weight loss, especially if it is accompanied by increased exercise, often reverses many of the health problems associated with this type of diabetes, and may return you to a completely normal blood sugar level. (At this point you no longer have the diabetes diagnosis, but you are susceptible to it, and it will return if you regain the weight.) High blood pressure, which often goes together with Type 2 diabetes, usually returns to normal with weight loss.
Diabetes causes heart disease through three main mechanisms. First, the high blood pressure that accompanies diabetes will harm the arteries as described above. Second, a diabetic is usually at higher risk from elevated blood triglyceride levels (over 200) and from lower levels ofHDL (below 35), the protective fraction of cholesterol. These two risk factors of blood lipids increase deposits of cholesterol in the heart arteries. The third risk factor is the high blood sugar itself: it isn’t understood why this occurs, but as blood sugar rises, the amount of cholesterol deposited in the arteries increases.

Whatever you do, don’t letyour diabetes go untreated! This is a wakeup call to lose weight, to increase exercise, to lower your sugar intake, and to work harder to lower any ofyour risk factors (by lowering blood pressure, triglycerides, and LDL; by increasing your HDL and your exercise levels). Exercise alone will lower blood triglycerides and raise HDL (these two occur together), and of course it will aid in weight loss and will help lower blood pressure. Exercise helps diabetics, even if no weight is lost, by increasing our muscles’ ability to take sugar out of the bloodstream. Weight loss itself, when achieved by diet alone, also lowers blood sugar, so the combination has a double benefit. If weight loss, increased exercise, and lowered sugar intake do not make your diabetes disappear, you must see your doctor and get one of the many medications now available to lower blood sugar. With a severe case of diabetes (in those with a strong genetic susceptibility), progression of the diabetes over time may eventually lead to a need for insulin injections. But the more you improve your lifestyle, the less likely it is that this will be needed.


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