Introduction

Functional and Selective Neck Dissection. The first thing that a title like this would bring to my mind would be something like, "What is this book about?''; "What will I get from it?''; "Is this worth the try (money)?''

More than 30 years ago we started to share our experience with functional neck dissection in head and neck cancer patients. At first, we were criticized for not being radical enough. Functional neck dissection was less than the standard cancer operation described by Crile; thus, its oncological safety was disputed. The years went by and we gradually witnessed a global shift toward less aggressive operations for early N stages. It seemed that the time for functional neck dissection had come. However, there was still criticism — now we were being too aggressive. It was time for selective neck dissections.

Throughout this period — when functional neck dissection was less than needed and when it apparently became more than required — we suspected that the problem was merely due to a lack of understanding of the concept of functional neck dissection. The operation is neither less aggressive than radical neck dissection nor more aggressive than selective neck dissection. It is simply different from radical neck dissection, and the basis for all types of selective neck dissections. Proving this is one of the main goals of this book.

There has been so much written about neck dissection in recent years that one can hardly believe there is still something new and interesting to add to the field. Thus, before we proceed, let us explain what we intend to present in this book, that is, what you can expect to find and what you will not find here.

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