Nonsimultaneous bilateral radical neck dissection

Abstract

From January 1963 to December 1977, 63 patients underwent a therapeutic second (staged) neck dissection at our institute. The mean interval between the first neck dissection and the second neck dissection was 13.2 months; 58.7% of the second neck dissections were performed between 6 and 12 months after the first. Forty-six patients had histologically positive and 17 patients had histologically negative nodes in the first neck clearance; 57 patients had histologically positive and 6 patients had histologically negative nodes in the second neck clearance. Forty-two of the 63 patients had bilateral nodal disease, while 2 patients had no disease in either side of the neck. Fifty-four percent of the patients had postoperative complications; 30% developed immediate postoperative edema, and 14% had wound infection. The overall three-year and five-year survival rates were 60% and 38%, respectively. Patients who had bilateral histologically positive nodes had a 16% five-year survival rate, while those who had histologically positive nodes in one side of the neck only had a 26% five-year survival rate.

Advantages of a new technique of neck dissection using an ultrasonic scalpel

“…Healing disturbances occurred in 61% (Magrin and Kowalski, 2000) of which the most frequent were wound infection and dehiscence. In the series of Baffi et al (1980), 30% of the patients developed severe postoperative oedema and 14% had a wound infection; the total complication rate was 54%. Cabra Duenas et al (1994) report on 43% complications in 195 functional neck dissections.…”

Neck dissection alternatives

“…Even staged bilateral neck dissections carry increased risk of complications. Long term survival of patients with bilateral positive neck nodes (N2c) is also poorer (Baffi et al, 1980). There is risk of raised intracranial pressure and blindness if bilateral ligation of internal jugular veins is carried out at the same sitting (De Vries et al, 1986).…”