ABSTRACT
The rationale for neck dissection is based on predictable patterns of lymphatic spread from the primary tumour site, and the relative risk of nodal metastatic disease. Despite many published studies, there is still controversy about neck dissection surgery and the reader should refer to specialist textbooks for a full discussion. When taking trainees through a neck dissection, the author makes the analogy of walking through a jungle. The principles of a more selective procedure are the same as for the levels I–IV neck dissection described, although it can be technically more challenging. The dissection usually starts inferiorly over the omohyoid muscle and proceeds superiorly as before. A study has found that the variables that contribute most to quality of life scores relating to the neck were age and weight, radiotherapy to the neck and type of neck dissection.
