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.

What is the nerve cutting operation for ulcers?

The nerve cutting operation is a method of treatment that was introduced in the 1940's. It has been done all over the world in tens of thousands of patients. The logic of cutting the vagus nerves (the wandering nerves that influence acid formation by the self stimulation of certain brain areas) is that it eliminates or markedly reduces the acid in the stomach. The procedure of cutting these nerves to eliminate their function is called a vagotomy. When the vagotomy is done, the surgeon also has to enlarge the stomach outlet or remove a part of the stomach. The ulcer can be left in because with this operation it will heal. A healed ulcer produces no symptoms and no complications. The procedure is technically easier than a gastrectomy and less of a strain on the patient. It appears to be about as effective, except in the patient with a bleeding ulcer.

When do you do which operation? 

No one size hat fits all heads. This decision is determined by the kind of person you are, what you weigh, how much acid you produce while sleeping (we can measure this), and what is actually found during the surgery. An original plan may have to be changed because of what is found. Very often both operations (nerve cutting and partial stomach removal) are done if it is felt that a belt and suspenders are the best way of keeping the pants up.


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