George Crile described the classical radical neck dissection in 1906 (see radical neck dissection). The boundaries of the radical neck dissection are shown, with removal of node-bearing tissue, along with the sternocleidomastoid muscle, the internal jugular vein, and the spinal accessory nerve.
In recent years, less radical dissections have been found to be equally effective when tailored to the nature of the primary lesion, and the pattern of spread for that particular lesion. If one or more of three structures, the sternocleidomastoid, the internal jugular vein, or the spinal accessory nerve, are spared, the procedure is termed a modified neck dissection. If all three are spared, the procedure is called a functional neck dissection.
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If the extent of clinically positive nodes is limited, a less extensive dissection is sometimes used. The lateral neck dissection outlined here includes levels II through IV.
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