Related Experiment Video
Updated: May 31, 2026
Modified Radical Neck Dissection for Cervical Metastasis
Published on: February 20, 2026
Efficacy of selective neck dissection for nodal metastasis with involvement of nonlymphatic structures
Muthuswamy Dhiwakar1, K Thomas Robbins, Krishna Rao
1Division of Otolaryngology-Head and Neck Surgery, Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois, USA.
Background:
Our aim in carrying out this study was to determine the efficacy of selective neck dissection (SND) for cervical metastases with clinical involvement of adjacent nonlymphatic structures.
Methods:
In all, 39 patients were retrospectively analyzed with respect to 43 extended selective neck dissection (ESND) procedures.
Results:
Eighteen procedures were performed as part of the primary treatment and 25 for salvage following (chemo)radiation. Although most patients (84%) had nodal disease ≥N2, 91% had disease clinically confined to ≤2 neck levels. SND (levels II-IV) was most commonly performed and the internal jugular vein was the nonlymphatic structure most often sacrificed. Recurrence rate in the ipsilateral targeted neck was 0% and 13% in the primary surgery and postradiation groups, respectively.
Conclusions:
SND that is extended to include adjacent nonlymphatic structures appears to be effective for advanced nodal metastasis confined to ≤2 nodal levels. We support the use of the term "extended selective neck dissection (ESND)" to describe this modification of neck dissection.
