How is modified radical neck dissection defined?

Updated: Aug 19, 2020
  • Author: Ron Mitzner, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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This operation involves the removal of the same lymph node groups as those involved in the radical neck dissection (levels I-V) but requires preservation of 1 or more of the following 3 nonlymphatic structures: the spinal accessory nerve, the internal jugular vein, and the sternomastoid muscle. The structure or structures preserved should be specifically indicated in the name of the procedure (eg, modified radical neck dissection with preservation of accessory nerve and internal jugular vein). [16]

Modified neck dissection is indicated for clinically palpable metastatic neck disease. Conversion to the radical neck dissection becomes necessary upon gross involvement of the nerve, vein, and muscle, although the involvement of all 3 is unusual, except in very advanced (N3) disease. Comprehensive neck dissection is a term that frequently appears in the literature. This term refers to any type of neck dissection that involves removal of lymph nodes from levels I-V and corresponds, therefore, to radical neck dissections and modified radical neck dissections, according to the Academy's classification.

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