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.

About Me

This health blog contains the questions that I've been most often asked by the patient facing surgery, his immediate family or concerned relatives. The confrontation has sometimes occurred at the bedside, often in a corridor corner, but most frequently in the privacy of the consultation room.
Over the years people have asked the same questions so frequently that I can now usually anticipate, for any disease, what concerns will be expressed. The queries are unrelated to education, social status, and sophistication in other areas. Susie O'Grady and the colonel's lady share the same anxieties, fears and uncertainties about the immediate decisions and the future results. I have, therefore, presented the inquiries in the patients' own words.
What patients are seeking is a concerned physician who has the technical knowledge to advise them about their disease, one who will also take "a few minutes" to discuss its effect on their work and family and whose experienced judgment may guide them in the necessary decisions.

The common denominator in all questions is the effort to understand what has happened and what is going to happen. The anxiety stems less from the presumed diagnosis and the contemplated surgical assault than from the uncertainty of the road to be traveled. "I wouldn't worry if I knew at every step what was going on and what I am to suspect." The patient's slip of the tongue here was "suspect" for "expect." She revealed the source of her anxiety. This stems not only from what is known but also from what is feared.
The answers are based on my experience. I don't intend to make an amateur surgeon of the inquirer. I acknowledge that there may be acceptable alternative attitudes and methods. I often can not solve the particular problem presented by the senile, suspicious grandmother, the financially concerned business partner, and the until now alienated first wife or the neighbor whose doctor advises a different approach.
I hope that making these facts available will help provide a basis of understanding for decision making and for a realistic adjustment to the surgical experience.

Dr S.N White



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