[Diagnosis and surgical treatment of metastatic cervical adenopathies]

Needle biopsy is preferable to open biopsy for several reasons; no tumor spread, no inconvenient scars hampering future surgical intervention, no delay between diagnostic procedure and definitive therapy as well as its simplicity. A conclusive histological diagnosis of malignancy is only made in 70 to 80% of the cases by this technic. In the other cases however, the macroscopic and microscopic aspect usually very strongly suggests the nature of the disease. When a definite diagnosis of malignancy cannot be made this way an open biopsy is mandatory and to be performed under general anesthesia by a surgeon who is able to proceed immediately with the appropriate surgical therapy as soon as a peroperatory positive histological diagnosis is obtained. The classical therapy consists of a unilateral or bilateral radical neck dissection with or without resection of the primary tumor. The postoperative follow-up is usually simple. The incidence of postoperative complications is higher when the cervical region has been irradiated with a dose equal or higher to 5,500 tumor rads or when the larynx, pharynx and/or buccal cavity have been entered.