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 a stent for heart attack? How serious is having a stent put in?

What are stents? 

New advances in the surgical management of coronary artery disease include the growth of the use of stents. These are implants made of inert material that are put in an artery to open it up. Stents have had great success in helping people who have very narrowed arteries. Advances are still being made in this area and it’s too early to know how successful they will be in the long run. It is important to be treated at a medical center that has had experience with these newer procedures to be sure of getting the best care.

It seems that stents are a step beyond angioplasty; is that correct? 

Yes. In angioplasty the coronary arteries are opened, but in 30 to 40 percent of patients, the arteries become narrowed again over time, and ECG exercise treadmill tests show that the blood flow through these arteries is poor. A stent could help prevent a recurrence of this narrowing, which is typical of many angioplasties.

Are there other types of intervention? 

There are other procedures that try to clean out the inside of the artery. An example is atherectomy. Here, as in angioplasty, a tube is inserted into the narrowed coronary artery. In one type of atherectomy, when the tube is in position, a balloon is inflated to hold the tube in place and a blade shaves the plaque from the wall of the artery. The shavings are collected in an attachment and removed when the instrument is taken out.

In a related procedure, a tiny drill attached to a tube is inserted into the problem area. Here the mini-drill grinds the plaque into small pieces that are flushed out by the circulating blood.

Other techniques that are at the forefront of heart surgery include the use of lasers, and studies are in progress to see if special forms of lasers can be used to remove some of the deposits in arteries. With the progress of electronic instrumentation, new techniques are likely to become available.


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