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Modified Radical Neck Dissection for Cervical Metastasis
Hongxuan Wei1, Zijian Guo1, Guangzhao Huang1
1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University.
Radical neck dissection (RND) and modified RND are key head and neck cancer surgeries. This guide details a precise protocol for RND and MRND, emphasizing oncologic control and functional preservation.
Area of Science:
- Head and Neck Oncology
- Surgical Oncology
- Anatomy
Background:
- Radical neck dissection (RND) is a century-old standard for cervical metastatic disease.
- Standard RND resects SCM, IJV, CN XI, and lymphatics levels I-V.
- Modified RND (MRND) preserves non-lymphatic structures to reduce morbidity.
Purpose of the Study:
- To present a detailed protocol for performing radical and modified radical neck dissection.
- To emphasize critical technical aspects for oncologic resection and neurovascular preservation.
- To demonstrate functional reconstruction and postoperative outcomes.
Main Methods:
- Step-by-step procedural video demonstration of RND and MRND.
- Emphasis on preserving vital structures: marginal mandibular, vagus, phrenic nerves.
- Detailed oncologic resection and functional reconstruction techniques.
Main Results:
- High rate of successful nodal clearance achieved.
- Minimal postoperative complications (<5% chyle leak/hematoma).
- Excellent functional outcomes in shoulder abduction and facial symmetry.
Conclusions:
- The presented protocol ensures oncologic efficacy with minimized functional morbidity.
- Precise nerve preservation techniques are crucial for optimal functional outcomes.
- This procedural demonstration is a valuable educational resource for head and neck surgeons.
