By Vijay P. Khatri MD FACS
Enhance your surgical services with Atlas of complex Operative surgical procedure! This new source choices up the place different surgical references depart off, delivering hugely visible, step by step tips on greater than a hundred complicated and complicated tactics in either normal and subspecialty parts.
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Extra info for Atlas of Advanced Operative Surgery
In some cases, a radical neck dissection is performed because extensive undermining and postoperative inflammation, scarring, or tumor dissemination obscure the relationship of the tumor to structures that may have been preserved otherwise. , in the treatment of the N0 neck). u 2 Chapter 1 • Radical Neck Dissection 3 II. OPERATIVE TECHNIQUE Position The patient is placed in the supine position. The operating table is usually rotated 90 degrees with the side to be operated on opposite the anesthesia machine.
U Now that the entire submandibular salivary gland is pulled posteriorly, the digastric muscle is fully exposed, along with muscles covering the digastric (styloid group of muscles: styloglossus, stylopharyngeus, and stylohyoid). The posterior belly of the digastric is pulled superiorly, and the internal jugular vein is identified. There may be a posterior occipital artery in this region crossing the internal jugular vein, which will require appropriate ligation. u Chapter 2 • Modified Neck Dissection 17 2nd cervical rootlets Spinal accessory nerve 3rd cervical rootlets Ansa cervicalis Phrenic nerve Internal jugular vein (cut) Vagus nerve Figure 2-7.
Other modified neck dissections include supraomohyoid neck dissection (commonly performed as a staging procedure—elective neck dissection—in patients with cancer of the oral cavity or oropharynx), the jugular neck dissection or anterolateral neck dissection (commonly performed for patients with tumors of the oropharynx and laryngopharyngeal area), and lateral neck dissection (mainly performed for patients presenting with metastatic melanoma or skin cancer posterior to the sternomastoid muscle).
Atlas of Advanced Operative Surgery by Vijay P. Khatri MD FACS