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January 1990

Prophylactic Neck Dissection

Author Affiliations

Birmingham, Ala

Arch Otolaryngol Head Neck Surg. 1990;116(1):15. doi:10.1001/archotol.1990.01870010017007

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Drs Michael Freidman, Mahmood F. Mafee, and Vytenis T. Grybauskas, Chicago, Ill, presented their findings regarding prophylactic neck dissection at the 1989 Triological Society meeting in San Francisco, Calif. The authors note that elective neck dissection has been recommended for patients at high risk for occult metastatic disease. The literature documents a wide range of false-negative results when decision making is based on clinical examination alone. The threshold for recommending prophylactic neck dissection also varies among authors, ranging from approximately 15% to 30%; this is the risk for occult metastatic disease that would justify proceeding with neck dissection. The use of computed tomographic scanning offers the potential advantages of increasing accuracy and of evaluating the contralateral neck, but the disadvantage of being a costly procedure.

The authors evaluated 182 patients who had undergone preoperative computed tomographic or magnetic resonance scanning. Of this group, 68 patients underwent neck dissection, having clinically

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