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Functional implications of radical neck dissection and the impact on the quality of life for patients with head and neck neoplasia.

Popescu B, Berteşteanu SV, Grigore R, Scăunaşu R, Popescu CR - J Med Life (2012)

Bottom Line: The surgical oncology procedure included the resection of the internal jugular vein, the sternocleidomastoid muscle, and the submandibular gland and the spinal accessory nerve.Deformities and impairment in the functionality of different regions of the neck and scapular regions have great implications on the quality of life of the patients who undergo such a procedure.Modifications to the radical neck dissection were made in the attempt to maintain the efficacy of the surgical oncology therapy.

View Article: PubMed Central - PubMed

Affiliation: E.N.T. Department, Coltea Clinical Hospital, Bucharest, Romania. dr.bpopescu@gmail.com

ABSTRACT
Radical neck dissection is a concept that was presented in 1906 by GW Crile and suffered constant improvement ever since. The surgical oncology procedure included the resection of the internal jugular vein, the sternocleidomastoid muscle, and the submandibular gland and the spinal accessory nerve. Deformities and impairment in the functionality of different regions of the neck and scapular regions have great implications on the quality of life of the patients who undergo such a procedure. Modifications to the radical neck dissection were made in the attempt to maintain the efficacy of the surgical oncology therapy. The authors try to assess the functional implications of radical neck dissection and the impact on the quality of life for patients with head and neck neoplasia.

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Related in: MedlinePlus

Radical neck dissection. Black arrow indicates the resected internal jugular vein. Blue arrow indicates the resected spinal accessory nerve.
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Figure 3: Radical neck dissection. Black arrow indicates the resected internal jugular vein. Blue arrow indicates the resected spinal accessory nerve.

Mentions: The removal of the internal jugular vein has minimal impact on the quality of life for head and neck cancer patients. Postoperative edema is a transitory condition that usually disappears in a week time. The collateral veins of the neck prevent the occurrence of this situation (Fig. 3). Despite this favorable situation, there is the need of limiting excessive hydration of the patient because of the possibility of inappropriate antidiuretic hormone secretion (ADH). The excessive ADH secretion, which in not uncommon in head and neck cancer patients, can lead to the accumulation of fluids in soft tissues. Persistent edema after radical neck dissections is unlikely to occur. Still, the removal of both internal jugular veins in the same surgical intervention is not to be performed because of the risk of having significant edema in the head and neck region that can be fatal for the patient. When needed, bilateral internal jugular vein resection, is to be done on a second stage procedure at least 6 weeks apart. This spacing allows the formation or the recalibration of collateral veins. When operating a patient with bilateral neck metastasis the tumor is to be resected in the second stage procedure along with the remaining contralateral neck metastasis. This follows the principle of resecting the tumor and the neck metastasis all together.


Functional implications of radical neck dissection and the impact on the quality of life for patients with head and neck neoplasia.

Popescu B, Berteşteanu SV, Grigore R, Scăunaşu R, Popescu CR - J Med Life (2012)

Radical neck dissection. Black arrow indicates the resected internal jugular vein. Blue arrow indicates the resected spinal accessory nerve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539843&req=5

Figure 3: Radical neck dissection. Black arrow indicates the resected internal jugular vein. Blue arrow indicates the resected spinal accessory nerve.
Mentions: The removal of the internal jugular vein has minimal impact on the quality of life for head and neck cancer patients. Postoperative edema is a transitory condition that usually disappears in a week time. The collateral veins of the neck prevent the occurrence of this situation (Fig. 3). Despite this favorable situation, there is the need of limiting excessive hydration of the patient because of the possibility of inappropriate antidiuretic hormone secretion (ADH). The excessive ADH secretion, which in not uncommon in head and neck cancer patients, can lead to the accumulation of fluids in soft tissues. Persistent edema after radical neck dissections is unlikely to occur. Still, the removal of both internal jugular veins in the same surgical intervention is not to be performed because of the risk of having significant edema in the head and neck region that can be fatal for the patient. When needed, bilateral internal jugular vein resection, is to be done on a second stage procedure at least 6 weeks apart. This spacing allows the formation or the recalibration of collateral veins. When operating a patient with bilateral neck metastasis the tumor is to be resected in the second stage procedure along with the remaining contralateral neck metastasis. This follows the principle of resecting the tumor and the neck metastasis all together.

Bottom Line: The surgical oncology procedure included the resection of the internal jugular vein, the sternocleidomastoid muscle, and the submandibular gland and the spinal accessory nerve.Deformities and impairment in the functionality of different regions of the neck and scapular regions have great implications on the quality of life of the patients who undergo such a procedure.Modifications to the radical neck dissection were made in the attempt to maintain the efficacy of the surgical oncology therapy.

View Article: PubMed Central - PubMed

Affiliation: E.N.T. Department, Coltea Clinical Hospital, Bucharest, Romania. dr.bpopescu@gmail.com

ABSTRACT
Radical neck dissection is a concept that was presented in 1906 by GW Crile and suffered constant improvement ever since. The surgical oncology procedure included the resection of the internal jugular vein, the sternocleidomastoid muscle, and the submandibular gland and the spinal accessory nerve. Deformities and impairment in the functionality of different regions of the neck and scapular regions have great implications on the quality of life of the patients who undergo such a procedure. Modifications to the radical neck dissection were made in the attempt to maintain the efficacy of the surgical oncology therapy. The authors try to assess the functional implications of radical neck dissection and the impact on the quality of life for patients with head and neck neoplasia.

Show MeSH
Related in: MedlinePlus