Neck dissection

Described by Crile in 1906

Various incisions

Classification

Radical Neck dissection
Level I to V lymph nodes
IJV, CN IX, SCM

Modified radical
Level I to V
One of three above saved

Selective
3 structures always preserved
Preservation of one or more lymph node groups


Complications
Nerve injury:mandibular branch of facial (runs superficial to facial artery and vein, 1cm anteroinferior to angle of mandible), hypoglossal (deep to IJV, ICA, CN vagus and accessory, turns 90 deg and passes b/w IJV and ICA, most commonly injured in flor of submandibular triangle just deep to duct) and vagus
Chylous fistula (left side 85%)
Flap necrosis esp if irradiated neck