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The ultimate modification in the modified neck dissection

G A Porter1, W J Temple, S Huchcroft

  • 1Department of Surgery, Faculty of Medicine, University of Calgary, Alberta, Canada.

American Journal of Surgery
|February 1, 1995
PubMed
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Preserving sensory nerves in modified neck dissections significantly reduces dysfunction. This study on head and neck cancer patients found no increase in regional recurrence when sparing these vital cervical plexus nerves.

Area of Science:

  • Surgical Oncology
  • Head and Neck Surgery
  • Plastic Surgery

Background:

  • Modified neck dissections are crucial for head and neck cancer treatment.
  • Preservation of cervical plexus sensory branches is debated.
  • Functional outcomes and recurrence rates are key considerations.

Purpose of the Study:

  • To evaluate the functional benefits of preserving sensory ventral branches of the cervical plexus.
  • To assess the impact of nerve preservation on regional recurrence rates in modified neck dissections.
  • To determine if sparing these nerves affects patient outcomes.

Main Methods:

  • A matched-pair study comparing 15 cases with nerve preservation to 15 cases with nerve sacrifice.
  • Inclusion criteria: squamous cell carcinoma or melanoma of the head and neck.

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  • Assessment included sensory loss evaluation, patient-reported dysfunction, and a minimum 2-year follow-up for regional recurrence.

    • Main Results:

    • Significantly reduced sensory loss in the group with preserved nerves.
    • Lower incidence of both acute and chronic dysfunction in the nerve preservation group.
    • No regional recurrence was observed in either the preserved or sacrificed nerve groups.

    Conclusions:

    • Routine preservation of sensory ventral branches of the cervical plexus is recommended when not directly involved by tumor.
    • Sparing these nerves improves functional outcomes without compromising oncological control.
    • This approach enhances patient quality of life following neck dissection.