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Clinical Challenges
December 2004

Is Selective Neck Dissection Adequate Treatment for Node-Positive Disease?

Author Affiliations




Arch Otolaryngol Head Neck Surg. 2004;130(12):1431-1434. doi:10.1001/archotol.130.12.1431

Hypothesis: Selective neck dissection (SND) is adequate treatment for node-positive neck disease.

Selective neck dissection, or the selective removal of nodal groups at risk for harboring cervical metastases, is an extension of the concept of the functional neck dissection first introduced in the 1960s. Until 1963, radical neck dissection (RND) was the standard surgical treatment of the cervical lymphatic nodes. In 1963 Suarez proposed a conservative, functional approach to neck dissection that was popularized by Bocca et al.1 These authors described the removal of cervical lymph nodes from levels I through V with their enveloping fascial sheath while sparing nonlymphatic anatomic structures adjacent to, but not containing, lymph nodes, such as the accessory nerve, internal jugular vein, and sternocleidomastoid muscle.1 The resulting modified RND (MRND) has been shown to avoid the cosmetic and functional morbidity associated with the classic RND without compromising oncologic safety or efficacy as a staging and therapeutic procedure.

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