Functional radical neck dissection.

A technique is described for performing a radical neck dissection by elevating the muscle out of the neck to facilitate the complete removal of all the neck structures without injury to the muscle and without significantly increasing the operative time. The neck dissection can be performed as a "classical" radical neck dissection by removing all the neck structures en bloc, including the jugular vein and spinal accessory nerve. Alternatively, a "functional" radical neck dissection can be done in selected cases by dissecting out and preserving the jugular vein and/or the spinal accessory nerve. The sternal end of the sternocleidomastoid muscle is then reattached before closing the neck wounds. This technique was used unilaterally in 11 patients and bilaterally in 2 patients, without complications. The cosmetic results demonstrate a significant advantage of this method over the routine classical radical neck dissection. The results in this small series, with follow-up periods of 18 to 40 months in patients with squamous cell carcinoma, suggest that this procedure gives good results in selected cases.