**Part 3**

**Advances and Modification of Neck Dissection**

68 Neck Dissection – Clinical Application and Recent Advances

[11] Prim MP,De Diego JI,Verdaguer JM. Neurological complications following functional

[12] Nader Saki, Soheila Nikakhlagh , Maryam Kazemi. Pharyngocutaneous Fistula after

Laryngectomy: Incidence, Predisposing Factors, and Outcome. Arch Iranian Med

neck dissection. Eur Arch Otorhinolaryngol.2006;263(5):473-476.

2008; 11 (3): 314 – 317

**5** 

Raja Kummoona

*Baghdad Iraq* 

*Chairman of Maxillofacial Surgery Iraqi Board for Medical Specializations,* 

**Lateral Cervical Flap a Good Access** 

An important and vital area of the head &neck entail the coverage of defects throughout the head and neck area. These defects usually covered by flaps, during the last 6 decades since the introduction of tube pedicle flap till the early sixty of the last century (Macgregor 1960) advocated his temporal fascial flap for coverage of intra oral defect after radical cancer surgey, this flap was a great advancement of radical surgery in the oro facial region. Advocation of flaps represent an artistic and fully acceptable of the nose, cheek, tongue,

We know that blood supply was important for survival of flaps and we have to pay attention to the distinct arterial and venous supply of any flap.Axialflaps such as musculocutanous flaps,fascio cutanous flaps and micro vascular free flaps were introduced in the decades of 1970,these flaps were rapidly used to greater number with clinical application in head and neck area and the concept of <delay> of flaps has been a banded

Flaps in general can be designed to be of an adequate dimensions and knowledge of its vascular supply and to be assured of a consistut satisfactory and acceptable result. Many flaps been advocated that differ not only in their design, type of flaps based on theblood supply is concerned. A number of soft tissue flaps have been used to reconstruct the oro facial region after ablative surgery , also random flaps been used successfully such as delto pectoral and cervico pectoral flaps but with limitation on use of these flaps in old people due to atherosclerosis. The aim is to repair the defect created by resection of tumor or a defect of post traumatic missile injuries of the face to restore function and provide an

1. Design of the flap and its elevation superiorly making a good access to resection of the mandible, supra omohyoid neck dissection, modified radical neck dissection and classical radical neck dissection, since other techniques forming a band of scar extended

and no more accepted as a method for reconstruction of the oro facial region.

**1. Introduction** 

floor of the mouth, chin and neck.1,2,3

acceptable cosmetic feature. 3, 4,6,8,9

**2. Indication of Lateral Cervical Flap** 

along the neck at the site of radical neck dissection

**for Radical Neck Dissection** 

*Professor Emeritus of Maxillofacial Surgery Acting* 
