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Selective (Supraomohyoid) Neck Dissection, Levels I-III
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Introduction
Neck dissection has been a standard method of removing at-risk or involved cancerous lymph nodes in the head and neck for more than 100 years. Crile first described the radical neck dissection in the early 1900s, but modifications by Bocca and others helped reduce the morbidity associated with lymph node removal, allowing for nerve and structure preservation when oncologically sound. This chapter discusses one of these modifications in detail, the selective or supraomohyoid neck dissection. A selective neck dissection, including levels I through III, is typically used for malignancies of the oral cavity in patients with N0 disease. When a larger nodal burden is present, an extended (levels I-IV) selective neck dissection or a modified radical neck dissection (levels I-V) is indicated. Lesions in the oral cavity that approach or cross the midline require treatment of both sides of the neck.
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