A new device for the identification of lymph nodes removed during different types of neck dissection

Imre Gerlinger, Tamás Ferenc Molnár, Tamás Járai, Péter Móricz, Gábor Ráth, Gyula Göbel
DOI: 10.4236/health.2010.29161                

Abstract

Meticulous mapping of the lymph node status is a general principle in present-day head and neck surgery. The removal of a certain number of lymphatic levels during neck dissection may well be therapeutic in intent, but it is also mandatory for correct tumour staging. We pre- sent a precise lymph node mapping during dif- ferent types of neck dissection in the course of major head and neck surgery by a sterile plastic tray moulded in the shape of the neck. This de- vice makes lymph node mapping simpler, safer, quicker and methodically more structured than any of the present methods. It facilitates the work of the pathologist and the flow of reliable information along the surgeon－pathologist- oncologist chain. With this device, a more stru- ctured, methodical means of lymph node removal has become possible.

Keywords

Head and Neck Surgery; Lymph Node Mapping; Neck Dissection

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Crile, G. (1906) Excision of cancer of the head and neck with special reference to the plan of dissection based upen one-hundred thirty-two operations. Journal of the American Medical Association, 47(22), 1780-1786.
[2]	Ferlito, A. and Silver, C.E. (1996) Neck dissection. In: Silver, C.E. and Ferlito, A., Eds., Surgery for Cancer of the Larynx and Related Structures, Saunders, Philadelphia, 299-324.
[3]	Suarez, O. (1963) El problema de las metastasis linfáticas y alejadas del cáncer de laringe e hipofaringe. Revista Brasileira de Otorrinolaringologia, 23, 83-99.
[4]	Houck, J.R. and Medina, J.E. (1995) Management of cervical lymph nodes in squamous carcinomas of the head and neck. Seminars in Surgical Oncology, 11(3), 228- 239.
[5]	Pellitteri, P.K., Robbins, K.T. and Neuman, T. (1997) Expanded application of selective neck dissection with regard to nodal status. Head Neck, 19(4), 260-265.
[6]	Molnar, T.F. (2006) A new device for the identification of lymph nodes at lung surgery. European Journal of Car- dio-Thoracic Surgery, 31(2), 311-312.
[7]	Ferlito, A., Som, P.M., Rinaldo, A. and Mondin, V. (2000) Classification and terminology of neck dissections. ORL: Journal for Oto-Rhino-Laryngology and Its Related Specialties, 62(4), 212-216.
[8]	Robbins, K.T., Medina, J.E., Wolfe, G.T., Levine, P.A., Sessions, R.B. and Pruet, C.B. (1991) Standardizing neck dissection terminology. Offical report of the academy’s committee for head and neck surgery and oncology. Archives of Otolaryngology－Head & Neck Surgery, 117(6), 601-605.
[9]	Ferlito, A. and Rinaldo, A. (1998) Selective lateral neck dissection for laryngeal cancer in clinically negative neck: Is it justified? Journal of Laryngology & Otology, 112 (10), 921-924.
[10]	Som, P.M., Curtin, H.D. and Mancuso, A.A. (1999) An imaging based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications. Archives of Otolaryngology－Head & Neck Surgery, 125(4), 388-396.
[11]	Shah, J.P., Strong, E., Spiro, R.H. and Vikram, B. (1981) Neck dissection: Current status and future possibilities. Clinic Bull, 11(1), 25-33.