NECK DISSECTIONS: MISCONCEPTIONS, MALPRACTICE AND COMMON CONTROVERSIES

Abstract

B a c k g ro u n d. Neck metastases are the single most important prognostic factor in Head and Neck Squamous Cell Carcinoma. Wise approach to neck treatment is then mandatory to give a chanche for cure. Still, there are some issues about neck dissection that need to be clarified. M e t h o d s. Through a review of the literature and of everyday clinical observations, the following issues are discussed: Functional Neck Dissection, biopsies, nodal levels, Selective Neck Dissections, Spinal Accessory Nerve, neck dissection classification. R e s u l t s. Integration of historical, anatomical, clinical and surgical concepts and up-to-date knowledge can allow to understand how to behave in diverse clinical situations. Conclusions. Standardized guidelines are far to be achieved. Wise behaviour, however, may allow to avoid some mistakes. The aim of this paper is to make the above mentioned issues clear and hopefully give more diffusion to concepts that too often seem to be overlooked.