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Chapter-03 Radical Neck Dissection

BOOK TITLE: Neck Dissections: Colour Atlas of Surgical Technique

Author
1. Medina Jesus E.
2. Vasan Nilesh R.
ISBN
9789386322289
DOI
10.5005/jp/books/14153_4
Edition
1/e
Publishing Year
2018
Pages
26
Author Affiliations
1. University of Oklahoma, College of Medicine, Oklahoma City, Oklahoma, USA
2. University of Oklahoma, College of Medicine, Oklahoma City, Oklahoma, USA
Chapter keywords
Radical neck dissection, RND, spinal accessory nerve, submandibular triangle, submental triangle, ramus mandibularis, fascia, submandibular gland, superior lateral dissection, inferior dissection

Abstract

This chapter seeks to familiarize the readers with radical neck dissection (RND). The RND removes lymph node groups I through V, the sternocleidomastoid muscle, the internal jugular vein, and the spinal accessory nerve. The dissection extends from the inferior border of the mandible superiorly to the clavicle inferiorly, and from the anterior belly of the digastric muscle and the lateral border of the strap muscles, anteriorly, to the anterior border of the trapezius, posteriorly. The patient is positioned on the operating table with the neck extended, if necessary, with a roll under the shoulders, the head turned towards the opposite side and stabilized with a foam doughnut. Different steps involved in the dissection of the submandibular and submental triangles, superior lateral dissection, posterior dissection, inferior dissection, and medial dissection are described briefly throughout this chapter with the help of well-illustrated diagrams and clinical images. In every case, serum and urine osmolality should be monitored to guide postoperative fluid replacement.

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