Premium
Crile's Neck Dissection
Author(s) -
Silver Carl E.,
Rinaldo Alessandra,
Ferlito Alfio
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e31813544b7
Subject(s) - medicine , surgery , neck dissection , lymphatic system , primary tumor , lymph node , head and neck , dissection (medical) , resection , head and neck cancer , cancer , metastasis , radiation therapy , immunology
George Crile, after a long experience with treatment of head and neck cancer and study of a large number of cases, appreciated that these tumors almost always drained through the lymphatic pathways of the neck, rarely metastasized distantly, and were thus theoretically curable by resection of the primary tumor and its lymphatic draining shed. After evaluation of his early failures, he found that a block resection of all of the lymph node‐bearing tissue of the neck in addition to resection of the primary tumor was the most effective means of obtaining a cure, particularly in patients with clinical evidence of spread of disease to the neck. Such radical surgery, at the time, was fraught with difficulty because of the lack of blood transfusion, antibiotics, and endotracheal anesthesia, but Crile devised several strategies for combating these obstacles. Crile performed 36 such block resections with a determinate 3‐year survival of 75% compared with 19% 3‐year survival in patients who had not undergone block resection. The surgical precepts developed by Crile laid the foundation for the effective modern surgical treatment of head and neck cancer.