We appreciate Leemans and Snow's response to our recent article. The definite answer to which procedure, the SND or MRND, is the appropriate type of neck dissection for the elective treatment of the N0 neck probably will never be scientifically determined. It is too subjective an issue. The results from the randomized study by the Brazilian surgeons presented at the Combined Meeting of the American Society of Head and Neck Surgery and the Society of Head and Neck Surgeons on May 14, 1998, in West Palm Beach is flawed in that the SND group had a frozen section performed on any suspicious node(s) and, if positive, the operation was converted to an MRND. This is the only randomized study that we know of that has appeared recently in the literature.
Clayman GL, Byers RM, Frank D. Is Selective Neck Dissection Really as Efficacious as Modified Radical Neck Dissection for Elective Treatment of the Clinically Negative Neck in Patients With Squamous Cell Carcinoma of the Upper Respiratory and Digestive Tracts?—Reply. Arch Otolaryngol Head Neck Surg. 1998;124(9):1044. doi:10.1001/archotol.124.9.1042
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