Posterolateral neck dissection

The posterolateral neck dissection is a regional lymphadenectomy of the retroauricular and suboccipital lymph nodes in continuity with the contents of the upper part of the posterior triangle and jugular chain. The procedure serves for the removal of occult or clinically manifest lymph node metastases of malignant epithelial tumors of the skin of the head and neck posterior to a coronal plane through the ear canals. The operation can be carried out unilaterally and bilaterally, while the spinal accessory nerve, the splenius capitis, and sternomastoid muscles are being preserved. Twelve patients, the majority with invasive melanoma, were treated with this procedure. A regional recurrence occurred in only one patient with extensive extranodal disease in the neck. The described procedure is adequate in gaining locoregional tumor control. Three patients died of generalized metastatic disease. The functional and cosmetic results are good.