The operative mortality in 230 radical neck dissections was 7.8%. The combination of total laryngectomy with "in-block" radical neck dissection had the highest postoperative mortality—15.5%—whereas radical neck dissection alone had a 1.5% postoperative mortality. Biotype of the patient, type of drainage utilized, and mobilization of the levator scapula muscle did not influence the postoperative course. Previous tracheostomy and preoperative radiation therapy increased the incidence of serious postoperative complications and postoperative deaths. Results using the T incision were far superior to those obtained with the classical Martin incision. Postoperative rupture of the carotid artery carried a 90% mortality. Clinical evaluation of cervical metastasis was 75% accurate in cases classified as positive and 60% accurate in negative cases.