Now that you know what this book is about, we would like to make a few comments on the things that you will not find in the following pages.
This book does not contain a detailed description of the surgical technique for all types of selective neck dissection. This is precisely what we try to avoid in an effort to stop further misunderstanding of the problem. Because selective neck dissections are regarded as technical modifications to the functional approach, they are all included in the general operative description. The step-by-step description of the complete surgical technique of functional neck dissection contains all the modifications that may be designed to treat the neck in patients with primary tumors from different sites, as long as these modifications follow the same rationale and basic indications of the original procedure. By describing the complete basic operation, all variations are included. Only specific surgical details of different types of selective operations will be mentioned in the text.
This book does not include an exhaustive discussion about the indications and usefulness of different types of selective neck dissection. History has proved the oncological safety of the concept of functional neck dissection for head and neck cancer. The nodal metastatic pattern for different head and neck primary tumors is well known, and some selective neck dissections have also proved to be totally safe. However, reducing the field of surgery creates a greater potential risk for leaving metastatic nodes behind. We cannot assure the oncological safety of all types of selective neck dissection on the basis of our own personal experience. Preserving some nodal groups in carefully selected patients has been demonstrated to be oncologically safe in our hands (e.g., not including area I in patients with cancer of the larynx). However, we have not sufficiently tested other selective operations. Thus, extensive discussion about the indications for different types of selective neck dissection according to the location of the primary tumor will not be included in this book.
Finally, this book does not intend to propose a new classification of neck dissection. Our purpose is to present the rationale, surgical technique, and evolution of ''less than radical'' neck dissection from a historical perspective, emphasizing a conceptual approach over technical considerations. We seek to connect and unify the American and Latin points of view and thereby to clarify the confused field of nonradical neck dissection.
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