What is a radical neck dissection? when is it done?

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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.

Do you need radiation for skin cancer?

How is skin cancer treated?

There are several ways of treating skin cancer. The most common ones are surgery and radiation therapy. However, heat, freezing (cryosurgery), chemotherapy, and immunotherapy are all being used in some instances.

What factors determine the treatment used?

The treatment depends upon many things: the type of growth, its location, its size, the rate of growth, the degree of extension and mestastasis, and whether or not it is a recurring growth. The doctor must also take into account the physical condition of the patient and how the person might respond to the various treatments. The treatment chosen should be the one which will give the best results both medically and cosmetically. The patient's preference should be taken into consideration.

When are surgery and radiation therapy used?

A small growth which is easily accessible is usually removed completely by surgery in the doctor's office. If the growth is large or is in a place where the surgery might leave a disfiguring scar, the procedure would be different. A biopsy would be done by removing a piece of the growth and having it checked microscopically to make sure it is cancer. If it is, there are several alternatives. Surgery would generally be used if it would leave a smaller and less visible scar. Radiation would be the treatment in areas where it gives better cosmetic results. For example, in an area such as the eyelids, where surgery would involve additional reconstructive work, radiation or one or more of the other treatments might be recommended.

When is a curette used?

A curette is a surgical instrument used to take out some lesions. Many of the skin tumors are scraped off the skin either with a scalpel blade or a curette a stainless steel hand tool. The open bottom has sharp edges which pry away a raised lesion.

When are heat or freezing used?

Electrocautery and the use of electric needles are sometimes used on small cancers. This treatment is usually performed in the office, and healing takes place in a week or two. Cryosurgery, in which the cancer is subjected to subzero temperatures without damage to underlying vital structures such as cartilage, is showing some promising results.

How does an electric needle work?

Sometimes the doctor uses an electric needle to take out the growth. He holds a stylus whose point is giving out raw cutting electricity. The amount of electricity is regulated with a foot pedal. Sometimes this treatment is called desiccation, which means "drying up."

Radiation therapy for skin cancer patients

When are chemotherapeutic drugs and immunotherapy used?

Chemotherapeutic drugs such as 5-FU in the form of ointment have been effective for both cancers and precancers of the skin. Chemotherapy and immunotherapy are used to treat melanoma and mycosis fungoides when these tumors have spread or to prevent spread.


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