Functional and selective neck dissection (IIa) following squamous cell carcinoma of the plate

Abstract

Background: Neck dissection has been an adjunct surgical procedure in the management of malignancies affecting the head and neck region. Radical neck dissection was the original surgical procedure for the treatment of regional neck metastases. The aim of this paper is to report the management of a female patient with regional neck metastases from squamous cell carcinoma affecting the hard palate.
Methods: A case report of a 60-year-old patient with squamous cell carcinoma of the palate who later manifested with an enlarged unilateral cervical lymph node ten weeks after surgery on the primary site. A functional and selective neck dissection in which the accessory nerve, internal jugular vein and sternocleidomastoid muscle were preserved and only the lymph node at the IIa level was removed was carried out under local anaesthesia.
Results: The malignant ulcer on the palate was excised and the neck was dissected to remove the clinically enlarged lymph node. These procedures were uneventful and patient was referred for post-operative radiotherapy for possible residual tumours.
Conclusion: There is need to reduce the morbidity and mortality associated with the radical neck dissection and this has led to the use of various levels of selective neck dissections as in the case presented.


Port Harcourt Medical Journal Vol. 1 (3) 2007: pp. 204-207