The feasibility of staged or simultaneous bilateral radical neck dissection has been adequately demonstrated. In 1961 Frazell and Moore1 reported 467 patients upon whom a two-stage bilateral radical neck dissection had been carried out. There were eight postoperative deaths (1.7%). Complications were observed in 30% of the patients, the most frequent being associated with faulty wound healing. Simultaneous bilateral radical neck dissection was first successfully performed by Perzik in 1949.2,3 In 1951 Moore and Smith4 reported 12 patients in whom the simultaneous procedure had been accomplished. There was one surgical death due to aspiration pneumonia. Equally favorable series have been reported since.5-9
In spite of these results, surgeons have feared the inherent physiologic consequences that may result from these bilateral procedures. The main objection has been the possible increase of intracranial pressure following removal of the jugular system of veins.
In 1960 a case of blindness