c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Classical Hayes Martin Radical Neck Dissection: 7

A D V E R T I S E M E N T

   
 

The internal jugular vein is divided above the clavicle and the vein reflected upward with the overlying muscles and lymph nodes. Care is taken to identify the thoracic duct on the left. The separation of the veins and mobilization of the lymphatics involves opening the areolar carotid sheath. The underlying vagus and phrenic nerves are identified and preserved. Posteriorly, the investing fascia is opened along the border of the trapezius and the accessory nerve lying on the levator scapulae muscle is divided and reflected upward. The branches of the cervical plexus to the skin of the neck and anterior branches of the internal jugular vein are divided in the course of the mobilization.     

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Classical Hayes Martin Radical Neck Dissection: 8

A D V E R T I S E M E N T

   
 

The upper end of the sternocleidomastoid muscle is divided near the mastoid process. The upper end of the accessory nerve and the internal jugular vein are divided as high as possible (the adjacent lymph nodes are the most critical in the dissection. The hypoglossal nerve is identified beneath the posterior belly of the digastric muscle and preserved.      

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Classical Hayes Martin Radical Neck Dissection: 9

A D V E R T I S E M E N T

   
 

The submandibular triangle between the anterior bellies of the digastric muscles is stripped and the submaxillary gland is mobilized, preserving the lingual nerve just above. The main submaxillary duct is divided and the remaining attachments in the region of the hyoid bone are separated.      

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This page was last modified on 11/10/1998.