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Table 5 Comprehensive neck dissection*

From: Neck dissections: radical to conservative

Neck dissection

Indication

Comments

RND

Clinically metastatic neck nodes of upper aero-digestive tract

Sternocleidomastoid, accessory nerve, Internal Jugular vein and submandibular gland removed

MRND TYPE I

As above, when accessory nerve away from nodal disease

Accessory nerve spared. Rest as RND

MRND TYPE II

Thyroid well differentiated cancer, nodes selectively involving IJV

Sternocleidomastoid, accessory nerve spared. Internal Jugular vein sacrificed. Rest as RND

MRND TYPE III

Thyroid well differentiated cancer

Sternocleidomastoid, accessory nerve, Internal Jugular vein spared

EXTENDED RND

Extensive involvement of nodes beyond usual levels or involvement of contiguous organs

Additional lymph nodes** or other non lymphatic structures removed

  1. IJV: internal jugular vein; RND: radical neck dissection
  2. * All procedures involve removal of nodes from level I through V
  3. ** Nodal areas include retropharyngeal, parapharyngeal, mediastinal or axillary, Structures include cranial nerves, carotid artery, muscles, skin etc.
  4. Note: It is recommended to uniformly use the term modified radical neck dissection (MRND) and not classify as I or II or III but instead name the structures preserved.