RADICAL NECK DISSECTION: THE FOLLOW-UP

AbstractObjective:To explore the diagnosis and treatment of carcinosarcoma of the larynx.Methods:Clinical information, including presentation, pathology, treatment and outcome, was obtained from a review of patient charts.Results:Seven male patients were confirmed pathologically to have had carcinosarcoma between 2003 and 2009 in our hospital. All patients underwent surgery: four total laryngectomies, two vertical partial laryngectomies, and one supracricoid partial laryngectomy-cricohyoidopexy. The mean follow up was 40.6 months. At the time of writing, six patients were alive and being followed; two of these suffered regional metastasis to the cervical lymphatic nodes and underwent radical neck dissection. One patient died of multiple distant metastases 60 months post-operatively.Conclusion:Carcinosarcoma of the larynx describes a biphasic tumour showing both carcinomatous and sarcomatous differentiation. It is extraordinarily rare and prone to metastasise to the cervical lymph nodes. Complete surgical resection of laryngeal primary lesions with wide margins and suitable neck dissection of cervical nodes is reasonable therapy.

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Bilateral Karapandzic flap: a work horse for carcinoma of lower lip

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200165 ◽

2020 ◽

Vol 6 (2) ◽

pp. 428

Author(s):

Mada Lakshmi Narayana ◽

Pramod D. ◽

Lavanya T. ◽

Vivek Viswambharan ◽

Urvashi Gaur

Keyword(s):

Neck Dissection ◽

Radical Neck Dissection ◽

Cervical Lymphadenopathy ◽

Lower Lip ◽

Contrast Enhanced ◽

The Face ◽

Supraomohyoid Neck Dissection ◽

Malignant Lesions ◽

Enhanced Computed Tomography

<p class="abstract">The lips are major aesthetic components of the face, which are also necessary for facial expression, speech, and eating. In oncological resections, the main goal in lip reconstruction is achieving oral competence than speech and facial expressions. Malignant lesions involving lip warrant a wide excision to ensure a disease-free margin, which usually results in large defects. Defects up to 1/3rd of lips are closed primarily. Defects measuring 1/3rd to 2/3rd of the lower lip may be closed with Karapandzic, Abbe or Estlander flaps. A 45-year-old male presented with an exophytic lesion in the lower lip involving the facial skin with bilateral level 1b cervical lymphadenopathy. Contrast-enhanced computed tomography scan showed heterogeneous irregular lesion over the lower lip with bilateral enlarged necrotic level 1b cervical lymphadenopathy. Biopsy from the lesion was suggestive of moderately differentiated squamous cell carcinoma. Wide local excision with left modified radical neck dissection and right supraomohyoid neck dissection was done. The central lower lip defect was reconstructed with bilateral Karapandzic flap. The postoperative period was uneventful, although the patient had microstomia. The patient was advised adjuvant radiotherapy based on histopathology and was in regular follow up.</p>

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Radical neck dissection: a 19-year experience

The Journal of Laryngology & Otology ◽

10.1017/s002221510011000x ◽

1989 ◽

Vol 103 (8) ◽

pp. 760-764 ◽

Cited By ~ 83

Author(s):

A. G. D. Maran ◽

M. Amin ◽

Janet A. Wilson

Keyword(s):

Carotid Artery ◽

Neck Dissection ◽

Radical Neck Dissection ◽

Digastric Muscle ◽

Surgical Incision ◽

T Stage ◽

Wound Breakdown ◽

N Stage ◽

Carotid Artery Rupture

AbstractA series of 394 radical neck dissections performed over the 17 year period 1969–1986 is presented. The shortest period of follow-up is two years. Of the major complications reviewed, wound breakdown was associated with T stage, prior radiotherapy and incision used but not with age or N stage. Cervical recurrence was associated with N stage, prior radiotherapy and surgical incision and inversely associated with age. Wound breakdown and recurrence were lowest in parotid primary tumours. Carotid artery rupture occurred in 17 patients (4.3 per cent), was fatal in all cases and was strongly associated with wound breakdown and previous radiotheraphy. The importance of the choice of incision, clearance of the posterior belly of the digastric muscle and carotied artery protection are discussed.

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Postoperative morbidity and quality of live in patients after radical and modified radical neck dissection

Acta chirurgica iugoslavica ◽

10.2298/aci0903149t ◽

2009 ◽

Vol 56 (3) ◽

pp. 149-153 ◽

Cited By ~ 3

Author(s):

A.S. Trivic ◽

V.B. Djukic ◽

S.B. Krejovic-Trivic ◽

J.P. Milovanovic ◽

P.D. Stankovic ◽

...

Keyword(s):

Neck Dissection ◽

Shoulder Pain ◽

Postoperative Morbidity ◽

Radical Neck Dissection ◽

Modified Radical Neck Dissection

Useful of radical neck dissection would not be questioned if the effects would be perfect. When postoperative morbidity is associated with oncological shortage of radical neck dissection in functional and cosmetics disfunction, looking for a new therapeutics procedures are justify. In our study were 319 patients. They were treated in period from 01. January 2000. to 31. December 2002. The follow-up was 5 year. We tried to consolidate distribution of n. accesorius operative injuries in modified radical neck dissection and relationship between shoulder pain and shoulder droop after modified and radical neck dissection. Injured n.accseorius in modified radical neck dissection was significantly decreased in patients with modified radical neck dissection. The frequency of patients is significantly different (?m 2= 26.662; df = 1; p<0.01) in categories of complications of n.accesorius (shoulder pain, shoulder droop). Shoulder pain and shoulder droop were significantly decreased in modified radical neck dissection (p<0.01).

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The Extent of Surgery for Thyroid Medullary Cancer

Tumori Journal ◽

10.1177/030089169408000604 ◽

1994 ◽

Vol 80 (6) ◽

pp. 427-432 ◽

Cited By ~ 11

Author(s):

Maria Rosa Pelizzo ◽

Paolo Bernante ◽

Andrea Piotto ◽

Antonio Toniato ◽

Maria Elisa Girelli ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Medullary Thyroid Carcinoma ◽

Radical Neck Dissection ◽

Stage I ◽

Stage Iii ◽

Medullary Thyroid ◽

The Impact

Aims Evaluation of the impact of the extent of primary surgery and reintervention on the outcome of patients with medullary thyroid carcinoma. Methods Seventy-two patients with medullary thyroid carcinoma (MTC) were surgically treated between 1967 and 1992. Results Fifty-five cases were sporadic, 5 patients had MEN 2A, 4 MEN 2B syndrome and 8 familial non-MEN MTC; 1 patient had stage I disease, 30 patients stage II, 36 stage III and 5 stage IV. Sixty-four had their initial treatment at our center, and 8 came for subsequent treatment. At first treatment, 8 patients were subjected to partial thyroidectomy, 10 to total thyroidectomy, 53 to total thyroidectomy with neck dissection, and 1 to only radical neck dissection; postoperative serum calcitonin (Ct) levels returned to normal in 3, 6 and 27 patients, respectively. In the patient with only radical neck dissection, Ct levels remained elevated. No patient with Ct normalization after surgery became responsive to pentagastrin in the follow-up. Thirteen patients had a reoperation due to nodal relapse. At a mean follow-up of 5.7 years (6-252 months), the 10-year survival rate was 84.5% with a significant difference between patients under and over 40 years of age (96.4 vs 57%), between stage I-II (100%) and stage III, IV (83.8%, 0% respectively). At the last follow-up, 36 (50%) patients were alive and disease free and 26 were alive with disease (15 with distant metastases). Of the 10 deaths, 7 were due to tumor recurrence, 3 to 120 months after surgery. Conclusions Data suggest that an earlier diagnosis rather than more extensive surgery could improve survival and reduce recurrences. However, the least treatment required is total thyroidectomy plus central neck and upper mediastinum clearance and in addition, according to the extent of nodal involvement, mono- or bilateral neck dissection. To avoid ineffective reoperation due to distant (mainly liver) micro-metastases, persistent residual microscopic disease requires a more aggressive restaging.

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Functional Neck Dissection

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948309200301 ◽

1983 ◽

Vol 92 (3) ◽

pp. 215-222 ◽

Cited By ~ 47

Author(s):

Carlo V. Calearo ◽

Gianpietro Teatini

Keyword(s):

Surgical Technique ◽

Neck Dissection ◽

Radical Neck Dissection ◽

Surgical Anatomy ◽

False Positives ◽

False Negatives ◽

Local Recurrences ◽

Functional Neck Dissection

The anatomical grounds of and surgical technique for functional neck dissection are described in detail in order to demonstrate that the radicalism of this procedure, from the viewpoint of surgical anatomy, is by no means less than that of the classical (so-called radical) neck dissection. From 1972 to 1978, 476 operations were performed (211 patients treated bilaterally and 54 unilaterally). The percentage of false negatives (ie, histologically proven metastases in clinically unsuspected nodes) was 14%, while the percentage of false positives (histological negativity in clinically suspected nodes) reached 53%. The total number of local recurrences in a three-year follow-up was nine (3.5%).

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