Neck Dissection Using the Fascial Plane Technique

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2025-03-03

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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery

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University of Cape Town

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Abstract
The importance of identifying the presence of metastatic neck disease with head and neck cancer is recognised as a prominent factor determining patients’ prognosis. The current available techniques to identify disease in the neck all have limitations in terms of accuracy; thus, elective neck dissection is the usual choice for management of the clinically N0 neck (cN0) when the risk of harbouring occult regional metastasis is significant (≥20%) 1. Methods available to identify the N+ (cN+) neck include imaging (CT, MRI, PET), ultrasound-guided fine needle aspiration cytology (USGFNAC), and sentinel node biopsy, and are used depending on resource availability, for the patient as well as the local health service. In many countries, certainly in Africa and Asia, these facilities are not available or affordable. In such circumstances patients with head and neck cancer whose primary disease is being treated surgically should also have the neck treated surgically.
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