Selective Neck Dissection for Oral Cancer

  • Krishnakumar Thankappan

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This video illustrates and describes selective neck dissection (SND) in a patient with early-stage oral squamous cell cancer. SND is the current standard of care in management of the node-negative neck in this cancer owing to the high propensity for neck nodal metastasis. SND is designed to remove, in a compartmental fashion, the cervical lymph nodes at risk for involvement by metastatic disease. The procedure is characterized by the preservation of one or more of the lymph node groups routinely removed in radical neck dissections as well as non-lymphatic structures. In this video, neck nodal levels I to III are cleared, starting with levels Ia and Ib and proceeding to levels II and III. The anatomical structures encountered are identified and all of the technical steps are clearly demonstrated.

Introduction

About the Author

Krishnakumar Thankappan

Krishnakumar Thankappan is a professor in the Department of Head and Neck Surgery and Oncology at Amrita Institute of Medical Sciences, Kochi, Kerala, India, where he teaches on the MCI-approved MCh program in head and neck surgery and oncology. Dr. Thankappan completed his basic training in Otolaryngology at BJ Medical College, Pune, his MCh in Head and Neck Surgical Oncology at Amrita Institute of Medical Sciences, Kochi, and his advanced fellowship in Head and Neck Oncology at Roswell Park Cancer Institute, Buffalo, USA. He also trained in robotic head and neck surgery in South Korea and has been responsible for initiatives to establish a robotic thyroidectomy program in India. Dr. Thankappan is the recipient of a Young Investigator Award from the Indian Co-operative Oncology network and has authored more than 60 publications in international journals. He serves as a reviewer for a number of international journals and is the Asia Pacific Regional Editor for the Journal of Cranio-Maxillary Trauma and Reconstruction. He has co-edited two previous books entitled “Basic Concepts in Head and Neck Surgery and Oncology” (Jaypee Brothers, 2015) and “Dysphagia Management in Head and Neck Cancers” (Springer, 2018)

 

About this video

Author(s)
Krishnakumar Thankappan
DOI
https://doi.org/10.1007/978-3-030-15259-8
Online ISBN
978-3-030-15259-8
Total duration
14 min
Publisher
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

[MUSIC PLAYING]

This video demonstrates a selective neck dissection, levels I to III, in a patient with oral cancer. I’m Dr. Krishnakumar Thankappan, a professor in the Department of Head and Neck Surgery and Oncology at Amrita Institute of Medical Sciences, Kochi. The NCCN guidelines suggest doing an elective selective neck dissection, levels I to III, in early stage oral cavity cancer.

The patient in this video had a T2 squamous cell carcinoma of the lower alveolus. The video is divided into two segments. First, the dissection of levels Ia and Ib and, second, the dissection of levels II and III. Let’s begin with the first section.