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European Journal of Oral and Maxillofacial Surgery 2022 April;6(1):31-5

DOI: 10.23736/S2532-3466.21.00276-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

A history of neck dissection

Sarah J. SIMPSON 1 , Sukhpreet DUBB 2, Vijay SANTHANAM 3

1 Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton, UK; 2 Department of Oral and Maxillofacial Surgery, Norfolk and Norwich University Hospital, Norwich, UK; 3 Department of Oral and Maxillofacial Surgery, Addenbrooke’s Hospital, Cambridge, UK



In the early XIX century, practitioners began to realize cervical swellings were associated with poorer prognoses for those with head and neck cancer. There was little success with initial attempts at removing cervical metastasis; this improved with developments such as general anesthesia and aseptic techniques. As time progressed, we started to move away from the initial radical en-bloc resections that became commonplace during the mid-XIX to mid-XX centuries. The 1960s introduced the functional neck dissection highlighting a more conservative approach with reduced morbidity and similar disease control outcomes. This led on to selective neck dissections in the late XX century, which focused on the removal of lymph nodes at the greatest risk of cervical metastasis. There are ongoing controversies surrounding the management of the clinically negative neck with elective neck dissections. Current research into sentinel lymph node biopsies within an intraoperative period may prove beneficial to these patients as an alternative to an elective neck dissection. There is also a look in the future to minimally-invasive neck dissections using endoscopic or robotic techniques.


KEY WORDS: Neck dissection; Head and neck neoplasms; Lymph nodes

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