Radical neck dissection: Oncological, aesthetic and functional approach in patients with head and neck cancer

Abstract

Background: The type of cervical incision is fundamental to achieve an adequate exposure to the lymphatic levels and to be able to perform a complete neck dissection and a proper staging of the patient; incomplete dissection sub-stages and increases the risk of recurrence. The incision must also offer the lowest morbidity, without aesthetic or functional sequelae; it must combine oncological safety with adequate aesthetics, functionality, and quality of life. Material and methods: A retrospective and observational study in which we evaluate the transverse cervical incision by knowing the number of dissected lymph nodes and complications rate associated to the incision. Results: Forty patients, 35 with squamous cell carcinoma metastasis and 5 with melanoma metastasis. The average of dissected lymph nodes was 25. A single incision allowed the dissection of the five ganglion levels; it was not necessary to convert the incision or make vertical enlargements; the cosmetic result was satisfactory in all patients, there were no significant complications. Conclusion: The transverse cervical incision allows access to the five cervical levels, in the present series the average of dissected lymph nodes was enough to consider the complete procedure. The aesthetic result was satisfactory, and there were no significant complications associated.