Neck dissection : its history from radical neck dissection to functional and selective neck dissection

DOI 1 Citations 16 References
  • Saikawa Masahisa
    Division of Head and Neck Surgery, National Cancer Center Hospital East
  • Ebihara Satoshi
    Division of Head and Neck Surgery, National Cancer Center Hospital East

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  • 頸部郭清術の変遷―根治的頸部郭清術から機能温存を主眼とする頸部郭清術へ―

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In 1906, Crile proposed the first systematic treatment for regional lymph node metastases from head and neck cancer: radical neck dissection (RND) . Since then, the usefulness and effectiveness of RND had been confirmed repeatedly and RND had been made the standard treatment for cervical metastases. The biggest problem with RND was its morbidity ; the loss of the spinal accessory nerve almost always resulted in "Shoulder syndrome." Many surgeons began to modify RND to reduce its morbidity, but the modification process was not easy because it required the same or higher curability as well as lesser morbidity. Only the best surgeons could attain this goal. Their vigorous and constant efforts led to the development of a large variety of new techniques for neck dissection, such as functional neck dissection and selective neck dissection. Today, these function-preserving operative methods play a leading role in surgical treatment of neck metastases. However, because there are now too many operative methods, there is no uniform nomenclature system for them. The indication of each method is different among surgeons. Surgeons are currently trying to standardize the terminology and indication of these modified operative methods.

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