Functional neck dissection. Anatomical grounds, surgical technique, clinical observations.

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Anatomy

Background:

• Classical neck dissection is a standard treatment for head and neck cancers with metastatic lymph nodes.
• Concerns exist regarding the extent of anatomical clearance and potential morbidity of classical neck dissection.

Purpose of the Study:

• To detail the anatomical basis and surgical technique of functional neck dissection.
• To compare the radicalism of functional neck dissection with classical neck dissection from a surgical anatomy perspective.

Main Methods:

• Detailed description of the anatomical grounds and surgical technique for functional neck dissection.
• Review of 476 functional neck dissections performed between 1972 and 1978.
• Analysis of false negative and false positive rates for lymph node metastasis detection.
• Three-year follow-up to assess local recurrence rates.

Main Results:

• Functional neck dissection demonstrates anatomical radicalism comparable to classical neck dissection.
• The study reported a 14% false negative rate and a 53% false positive rate.
• A total of 3.5% local recurrences were observed within the three-year follow-up period.

Conclusions:

• Functional neck dissection is an anatomically radical procedure for managing neck metastases in head and neck cancers.
• The technique achieves low local recurrence rates, supporting its efficacy.
• Functional neck dissection represents a viable alternative to classical neck dissection.