**Part 2**

**Different Techniques of Neck Dissection & Complications**

22 Neck Dissection – Clinical Application and Recent Advances

Wolf et al. Induction chemotherapy plus radiation compared with surgery plus radiation in

Laryngeal Cancer Study Group. N Engl J Med. Jun 1991;324(24):1685-90.

patients with advanced laryngeal cancer. The Department of Veterans Affairs

**2** 

*India* 

**Neck Dissection –** 

Jaimanti Bakshi1, Naresh K. Panda2,

*3Dept. Of Otolaryngology&HNS, PGIMER* 

**Techniques and Complications** 

Abdul Wadood Mohammed3 and Anil K. Dash4 *1Dept. Of Otolaryngology&HNS, PGIMER, CHANDIGRH 2Dept. Of Otolaryngology&HNS, PGIMER, CHANDIGARH* 

*4Dept. Of Otolaryngology&HNS, PGIMER, CHANDIGARH* 

"Neck dissection" refers to the surgical procedure where the lymphatics and the fibro fatty tissue of neck are removed as a treatment for cervical lymphatic metastasis. As malignancies of the upper aero-digestive tract mainly metastasize to the cervical lymph nodes, neck

The cervical lymph nodes are surgically divided into six levels. Each level of lymph node is interconnected by lymphatic channels and drain specific anatomic sites of the aero-

It is the midline group bounded on both sides by the anterior belly of digastrics and the hyoid bone inferiorly. Tumors of floor of mouth, anterior oral tongue, anterior mandibular

These are the lymph node groups bounded by the anterior and posterior belly of digastric and mandible superiorly. The submandibular gland is usually included in the specimen when this group of lymph nodes is removed. Cancers of oral cavity, anterior nasal cavity, soft tissue structures of mid face and submandibular gland commonly metastasize to this

This group of lymph nodes is related to the upper 1/3rd of the internal jugular vein. They are bounded by the skull base above , inferior border of hyoid bone below , lateral border of sternohyoid and stylohyoid anteriorly and posterior border of sternocleidomastoid posteriorly. This group is further divided by the vertical plane in relation to the spinal accessory nerve. Level 2a is anterior to this plane and level 2b is posterior. Cancers of oral

dissections are performed along with surgical excision of these malignancies.

**1. Introduction** 

**2. Relevant anatomy** 

**Level 1a** – sub-mental group

**Level 1b** – submandibular group

**Level 2a and 2b** – upper jugular group

group of lymph nodes.

alveolar ridge, and lower lip metastasize to these nodes.

digestive tract.
