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 normal homocysteine levels in blood? How does homocysteine damage arteries?

I've never heard of homocysteine. Is it a serious risk factor? 

While some research as far back as 2001 showed that homocysteine was a risk factor, it was only recently that we found out the major role it may play in heart disease. Homocysteine is one of the many amino acids (the building blocks of our bodies’ proteins) found in the blood. Many clinical laboratories are now measuring it. Higher levels of homocysteine cause heart disease by increasing the tendency of blood to clot and by damaging the walls of the arteries, which favors cholesterol deposits. It was thought that normal levels of homocysteine were between 5 and 12 micromoles per liter, but new evidence points out that you should be concerned when your level is over 9 micromoles per liter. Moreover, it appears that an increase in your blood homocysteine level of even a few units increases your risk of heart disease: a 5 unit increase could be as bad as a 30 milligram increase in blood cholesterol.

Although high levels of homocysteine are found in people with the rare genetic disorder homocystinuria, they more commonly occur in people whose diets are low in folic acid (a vitamin in the B-complex group) and also low in vitamins B6 and B12 . Other factors that increase homocysteine levels in the blood are a diet high in animal protein, smoking, heavy consumption of unfiltered coffee, stress, estrogen deficiency, and low thyroid hormone.

In addition to increasing the risk of heart disease, high homocysteine levels have been linked to increased risk for dementia (such as Alzheimer’s disease), to the deterioration of eyesight with aging, to stroker to hypertension, and to various problems in pregnancy and lactation such as premature delivery, low birth weight, early miscarriage, and neural tube defects.

How can I lower my homocysteine level? 

Eating lots of legumes (especially lentils), whole grains, fruits, and vegetables helps homocysteine levels return to normal. As B vitamins are soluble in water, it is best to steam or microwave vegetables with little or no water. Despite a healthy diet with an adequate amount of folic acid, some individuals may need supplemental amounts. Some easy steps to help lower your homocysteine level are: take a good multivitamin supplement that contains folic acid, B 6 , and B 12 ; decrease meat and other animal protein intake, or eliminate meat altogether if your homocysteine level is very high; find some time every day for meditation to relieve stress; limit alcohol intake; avoid drinking strong coffee; and exercise more. And do not smoke.

Remember that the steps that help lower homocysteine levels are the same that help reduce other heart disease risk factors.


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