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.

Is the bulge in my groin a hernia? Why isn't it present all the time? Could it be something else?

It is a hernia because the bulge increases in size when you strain and it hits against the examining finger when you cough. You yourself can hear a gurgle in the intestine as the lump is pushed back. Note also that it completely disappears when you lie down.

The hernia can fall back into the abdomen and may not be obvious ("reduced" is the medical term) especially during the night when you lie down. Some small hernias become apparent only after a day's work, walking or straining, or jumping up and down and exercising. Hernias which have been present for a long time may remain in the scrotum and may not fall back so readily. Many patients learn to manipulate the hernia back with all sorts of hokus-pokus hand movements and contortions of the thighs. But this method accomplishes its purposes. Don't criticize it! However it can be an uncomfortable way to get along.

The diagnosis of a groin hernia is usually easy. As a matter of fact, the patient usually makes it himself and only comes for advice regarding what to do about it. However, the lump can occasionally be confused with a tumor, a lymph gland, a large varicose vein, or fluid in the scrotum. Only a hernia goes in and out, and only a hernia has gas and fluid gurgles.

What is hernia

 A HERNIA is an abnormal protrusion of a body part into a space in which it normally does not enter or reside. The organ is normal, but its position is abnormal. Any body organ can become herniated. The commonest type is the groin or inguinal hernia. The contents of the lower part of the abdominal cavity are confined in position by a lining membrane called the peritoneum. The derivation of the term from the Greek peri, meaning "all around," and tenere, "to hold," clearly indicates its function. In each groin area just above the scrotum or vulva there is a potential area of weakness. This can be likened to a room with two normally closed doors. When the wall of the room weakens or the door opens, the possibility for this type of hernia exists. The two doors are the right and left groin openings called the inguinal rings through which the testicle passed on its way into the scrotum. A comparable opening also exists in the female, and through it passes a ligament that supports the womb. These rings, openings, doors call them what you will normally close tightly and don't allow anything to pass through. Groin hernias arise allow anything to pass through. Groin hernias arise when the opening is stretched and becomes larger or when the lower lining area becomes lax and bulges, so it can no longer retain the abdominal contents in their normal position.


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