This richly illustrated guide provides a detailedstep-by-step description of the operative techniques employed in selective andradical neck dissection. The authors share the lessons of their extensiveexperience, giving precise surgical instructions specific to these procedures.Actual intraoperative photos, in combination with high-quality drawings, areused to explain all the essential steps. Anatomic variations are discussed and practicalpearls and pitfalls, highlighted.

 

Neck dissection is an integral part of themanagement of patients with head and neck cancer. The complexity of the headand neck region makes this procedure an inherently delicate undertaking forsurgeons from different specialties who treat head and neck cancer. This book willbe an essential resource for trainees and practicing surgeons in the fields ofhead and neck surgery, oral and maxillofacial surgery, reconstructive surgery,and oncologic surgery.?

DietmarThurnher has been Professor of ENT Diseases at Graz University, Austria sinceMarch 2015. He was previously Deputy Head of the Department of Otolaryngology,Head& Neck Surgery at Vienna Medical University. His research priorities concernthe prognosis and treatment of cancer in the head and neck region, and especiallytranslational research and the development of new therapeutic molecules. He isthe author/co-author of several textbooks, including the German-language titleHNO-Heilkunde. Ein symptomorientiertesLehrbuch(ISBN 978-3-211-88984-8).

Part 1 Introduction.-Definition and types of neckdissection.- Pre-operative investigations.- Operative set-up.- Recommendedinstruments. Part 2 Selective NeckDissection.-Positioning of the patient.- Marking of the skinincision.- Skin incision and exposure of platysma.- Elevation of cranial andcaudal subplatysmal flaps.- Identification of the marginal ramus of the facialnerve.- Identification of the anterior belly of the digastric muscle.- Dissectionof the tissue along the mandible and litigation of the facial artery and vein.-Identification and dissection of the mylohyoid muscle.- Identification of the lingualnerve.- Identification and ligation of the submandibular duct.- Identificationof the hypoglossal nerve.- Finalization of level I dissection.- Dissection ofthe investing fascia along the anterior border of the sternocleidomastoid muscle.-Elevation of the sternocleidomastoid muscle.- Identification and dissection ofthe accessory nerve.- Identification of the digastric muscle.- Identificationof the internal jugular vein.- Completion of the dissection of the accessory nerve.-Dissection of level 2b.- Identificationof the hypoglossal nerve.- Definition of the inferior border of the dissection.-Definition of the lateral border of the dissection.- Dissection of the tissuelateral to the internal jugular vein.- Dissection of the tissue off the internaljugular vein.- Dissection of the tissue medial to the internal jugular vein.- Enbloc removal of tissue.- Irrigation and hemostasis.-Insertion of suction drains.- Wound closure in multiple layers.- Skin incisionand dissection of the platysma.- Elevation of cranial and caudal subplatysmalflap.- Dissection of the anterior border of the sternocleidomastoid muscle.- Elevationof the sternocleidomastoid muscle.- Identification of the accessory nerve at levelsII and V.- Complete elevation of the sternocleidomastoid muscle.- Identificationof the anterior border of the trapezius muscle.- Complete dissection of the accessorynerve.- Identification of the digastric muscle and internal jugular vein.- Dissectionof level 2b.- Identification of the marginal ramus of the facial nerve.- Identificationof the anterior belly of the digastric muscle.- Dissection of the tissue along the mandibleand ligation of the facial artery and vein.- Identification and dissection ofthe mylohyoid muscle.- Identification of the lingual nerve.- Identification and litigation of the submandibularduct.- Identification of the hypoglossal nerve.- Finalization of level Idissection.- Identification of the internal jugular vein above the clavicle.- Identificationof the vagus and phrenic nerves.- Definitionof the inferior and deep border.- Horizontal dissection above the clavicle.- Identificationof the brachial plexus.- Dissection of lymphoid tissue from lateral to medial partI.- Dissection of lymphoid tissue from lateral to medial part II.- Dissectionof lymphoid tissue from lateral to medial part III.- Dissection of lymphoidtissue from lateral to medial part IV.- En bloc removal of specimen.- Irrigationand Hemostasis.- Insertion of suction drains.- Wound closure in multiple layers.- Part 3 Radical Neck Dissection.- Skinincision and dissection of the platysma.- Elevation of cranial and caudal subplatysmalflap.- Identification of the trapezius muscle.- Resection of the cranialinsertion of the SCM muscle.- Resection of the caudal insertion of the SCM muscle.-Identification and ligation of the internal jugular vein cranially.- Identificationand ligation of the internal jugular vein caudally.- Identification of the marginal ramus of the facialnerve.- Identification of the anterior belly of the digastric muscle.- Dissectionof the tissue adjacent to the mandible in the facial artery and vein.- Identificationand dissection of the mylohyoid muscle.- Identification of the lingual nerve.- Identificationand ligation of the submandibular duct.- Identification of the hypoglossal nerve.-Finalization of level I dissection.- Definition of the inferior and deep border.-Horizontal dissection above the clavicle.- Dissection of lymphoid tissue fromlateral to medial part I.- Dissection of lymphoid tissue from lateral to medialpart II.- Dissection of lymphoid tissue from lateral to medial part III.- Enbloc removal of specimen.- Rinsing and coagulation.- Insertion of suctiondrainage.- Wound closure in three layer.- References.