Conservative neck surgery in squamous cell carcinoma

Squamous cell carcinoma of the upper aerodigestive tract metastasises to lymph nodes in the upper-deep cervical group. Control of these metastases is the single most important prognostic factor in the management of this disease. Traditionally, surgical control was achieved by the radical neck dissection, a mutilating procedure with significant morbidity. Contemporary research has led to an improved understanding of the patterns of nodal metastases. This has led to the evolution of more conservative techniques that still produce comparable results of control. This paper describes this evolutionary process, and the current management thinking.