Neck Dissection

treatment
The
goal ofsurvival and of cervicalcontrol
lymph node metastasis is

improved regional of neck disease .

neck
Management of
✓

NO N -1

Management of No neck

dissection
'

D Cruz etat
compared Elective 4s Therapeutic neck
•

negative
in node oral cancer .

concluded that in
they OS and DFS was better the

Elective neck dissection

group .

Management of primary dictates the

management of
•

neck .

if RT is irradiated
primary is
managed by Neck
> →

if is dissection is
>
primary managed by surgery → neck

done .

surgical treatment
-

knowledge of
cervical
lymphatics and levels
of lymph
nodes is
important .
 Classification
Neck dissection

r v

comprehensive ND selective ND

Removal nodes select level

of neck
Only a
• -

removed
from level I to I
of cervical nodes .

v
✓

done in N+ neck . done in No neck

 Comprehensive neck dissection
•

Comprehensive removal
of cervical
lymph nodes
from
level I to I

v v v

Radical ND Extended Radical ND

Modified Radical ND
•
levels I to I •
RND •
levels Ito I
1- ¢
-

preservation of
3
lymphatic
non str
. Additional LNS
/ 71 non
lymphatic Str .

)
Spinal Accessory iv. CSAN
sacrifice of other str
-
.

( ITV) ( / / skin)
Internal
Jugular muscle
-
v. c. N

stetnocleidomastoid (Sem)

Modified RND

v v v

Type I III III

-
levels I to I removed .
levels Ito I removed .
levels Ito I
Preservation
Preservation
of SAN of SAN -1s 'M removed
-
~

C-removal
of tsvtscm ) ( Removal
of ITV ) .
SAN tscm
1- ☐ ✓
preserved
(Functional ND)
 Selective Neck Dissection
in
It is
usually performed No need
•
.

see Eline site

.
The
type of ND
depends on the
of primary
tumour .

Supraomohyaid ND

-B@@BT_@BÉ-@@q@fg@
⑧g②fg←-

•
Extended
Supraonrolryoid ND

BtfAABh%@@⑨@@@A@
g
•
Lateral ND

•
Posterolateral MD
 Central
compartment ND
•

OMB