J.L. Gluckman, J.T. Johnson: Surgical Management of Neck Metastases

J.L. Gluckman, J.T. Johnson: Surgical Management of Neck Metastases Eur J Plast Surg (2004) 26:433 DOI 10.1007/s00238-003-0591-9 BOOK REVIEW L. Clodius Dunitz, London, 2003, 192 pp (ISBN 1-90186-585-1), $85.00 US Published online: 23 January 2004 Springer-Verlag 2004 This reviewer had the chance of a special training in head expectant treatment, surgery versus irradiation. A classi- and neck surgery (Roswell Park Memorial Institute, fication of the possible types of neck dissection is given Buffalo, NY). At that time, generally, a radical neck and discussed including radical, modified-radical, supra- dissection was considered routine, worthy of technical hyoid, posterolateral and anterior-compartment dissec- discussions only. But, what about the incision, if an intra- tion. These various approaches and their technical aspects oral malignancy must be removed at the same surgical are outlined, explained and discussed in separate chapters. procedure? Should the platysma be included in the What may we do, if there is no clinical evidence of specimen? If you cannot find the primary tumour, but neck lymphadenopathy? An intriguing difficult question, have a palpable neck-node: what should you do? J.J. this is discussed on the basis of all available parameters Conley, the former “grand-master” of head and neck today. How must we best, taking into account the surgery, once told me: “A surgeon, who removes a single characteristics of the primary tumour, evaluate the neck? neck node, is a dangerous surgeon”. To summarize: a Outlined within the text are: physical examination, radical neck dissection is more than simple routine. The imaging (CT, MRI and ultrasound, also with ultrasound- two editors in their preface state that: “This book is guided fine-needle biopsy), sentinel lymph-node biopsy, intended to present to the reader the current- ‘state of the functional imaging (PET, magnetic resonance spectros- art’ emphasizing areas of proven efficacy while drawing copy) and lymphangiography. The text on complications the reader’s attention to evolving new techniques”. of neck dissections not only lists them, but also provides The contents: Surgical anatomy of the neck, this the advice on how to avoid and how to treat them. includes the various incisions, the important fascial layers The book is concluded by chapters on controversies in and spaces, the cervical triangles, the muscles of the neck the management of advanced and recurrent cervical and their important relations e.g., to the carotid artery and metastases, and on non-surgical management of metas- internal jugular vein; the lymph nodes (one third of all tases. Each chapter is supplemented by a pertinent list of nodal tissue is in the neck), their anatomy, location and references, and a list for recommended reading. levels. This excellently produced and profusely illustrated Chapter 2: Pathophysiology of nodal metastases and volume is a first on radical neck dissection. It is highly rationale for neck dissection. The controversies about the recommended. ideal management of cervical lymphatics are discussed and the extent of lymphadenectomy, elective versus L. Clodius ( ) Zurich, Switzerland http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

J.L. Gluckman, J.T. Johnson: Surgical Management of Neck Metastases

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