The problem of unilateral and bilateral neck dissection.

270 unilateral and bilateral neck resections have been performed in different primary localisations of tumours in the head and the neck at the Ear, Nose and Throat Department of the Medical Faculty in Zagreb in the period 1960-70. Of 209 patients with unilateral resection, only 78 survived (37%), while only 3 patients (4.9%) survived of a total of 61 patients where bilateral resection was performed. An analysis is given separately of radical resection in carcinoma of the larynx, the hypopharynx and the skin. From this analysis and from immunologic considerations, the following conclusions are derived: (i) The authors are not in favour of prophylactic block resection as this would be contrary to our knowledge of the role played by the immunobiological factors in the struggle against the malignant lesion. (ii) Evacuation of the neck must be performed in carcinoma of the larynx T3 and in hypopharyngeal carcinoma, as histologically positive lymph nodes are usually found in this site in large numbers.