Complete excision of the glands of the neck for malignant disease consists of excision of the submental lymphatic glands; unilateral excision of the submaxillary lymphatic and salivary glands and of the occipital, the deep cervical, the paratracheal, the prelaryngeal, the superior anterior cervical, and the infrahyoid lymphatic glands, and resection of the sternocleidomastoid and the omohyoid muscle, and of the internal jugular vein (fig. 1). Descriptions of the operation by Crile and others1 are in the literature. Each operator's technic naturally is a little different, and, as others have noted, many complete block dissections of the glands of the neck are such in name only; therefore, even at the risk of repetition, it seems well to describe mine.
The position of the patient on the operating table is flat on the back with the neck extended. The incision in the skin extends from the mastoid process of the temporal