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The neck dissection is a surgical procedure for control of neck lymph node metastasis. This can be done for clinically or radiologically evident lymph nodes or as part of curative surgery where risk of occult nodal metastasis is deemed sufficiently high. The aim of the procedure is to remove lymph nodes from the neck into which cancer cells may have migrated. Metastasis of tumours into the lymph nodes of the neck is one of the strongest prognostic indicators for head and neck cancer. The metastases may originate from tumours of the upper aerodigestive tract, including the oral cavity, tongue, nasopharynx, oropharynx, hypopharynx, and larynx, as well as the thyroid, parotid and posterior scalp. Neck nodal metastasis can sometimes also originate from lung cancer or intra-abdominal malignancy. However, neck dissection is rarely performed for such purposes. Lymph nodes in a particular region are numerous and generally referred to in groups. It is impossible to dissect through all the soft tissue to remove individual lymph nodes. As such the neck dissection is the en-bloc resection of all soft tissue in the region including all the lymph nodes and structures passing through them. In the case of a neck dissection, this entails the resection of everything within the superficial layer of deep cervical fascia (also known as the investing layer of cervical fascia). Where deemed excessively morbid, the structures within are conserved. These include the carotid and in some instances the three structures - IJV, SCM and Accessory Nerve. ==History of Neck Dissections== * 1888 - Jawdynski described en bloc resection with resection of carotid, internal jugular vein and sternocleidomastoid muscle. * 1906 - George W. Crile of the Cleveland Clinic describes the radical neck dissection. The operation encompasses removal of all the lymph nodes on one side of the neck, and includes removal of the spinal accessory nerve (SAN, or CN XI), internal jugular vein (IJV) and sternocleidomastoid muscle (SCM). * 1957 - Hayes Martin describes routine use of the radical neck dissection for control of neck metastases. * 1967 - Oscar Suarez and E. Bocca describe a more conservative operation which preserves SAN, IJV and SCM. * Last 3 decades - Further operations have been described to selectively remove the involved regional lymph groups. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Neck dissection」の詳細全文を読む スポンサード リンク
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