The neck dissection is a surgical procedure for control of neck lymph node metastasis from squamous cell carcinoma (SCC) of the head and neck. The aim of the procedure is to remove lymph nodes from one side of the neck into which cancer cells may have migrated. Metastasis of squamous cell carcinoma into the lymph nodes of the neck reduce survival and is the most important factor in the spread of the disease. The metastases may originate from SCC of the upper aerodigestive tract, including the oral cavity, tongue, nasopharynx, oropharynx, hypopharynx, and larynx, as well as the thyroid, parotid and posterior scalp.

History of neck dissections

Division of the neck into levels and sublevels

To describe the lymph nodes of the neck for neck dissection, the neck is divided into 6 areas called Levels. The levels are identified by Roman numeral, increasing towards the chest. A further Level VII to denote lymph node groups in the superior mediastinum is no longer used. Instead, lymph nodes in other non-neck regions are referred to by the name of their specific nodal groups.

Classification of neck dissections

The 2001 revisions proposed by the American Head and Neck Society (AHNS) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) are as follows.