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.

Who usually gets CLL?

Chronic lymphocytic leukemia (CLL) is a disease of old or middle age in which there is an abnormal increase in lymphocytes. The course ofCLL varies a great deal from person to person. Generally, however, the disease begins slowly and progresses to an aggressive stage after a period of years. Scientists disagree on the best treatment for the early stage of CLL. Current thinking favors monitoring the patient and delaying anticancer treatment until symptoms, such as anemia or lymph node enlargement, appear.

Most patients respond well to moderate doses of chemotherapy. Radiation therapy also produces remission in a large number of patients. Initially CLL responds well to treatment. In its later stages, however, leukemic cells develop resistance to therapy and most patients relapse. Various studies are under way, using experimental chemotherapies both as single or combination drugs, to overcome such drug resistance.


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