From the Guidelines
The answer is (e) posterior belly of the digastric muscle. In a radical neck dissection, the posterior belly of the digastric muscle is preserved while the other structures listed are removed. Radical neck dissection is an extensive surgical procedure typically performed for advanced head and neck cancers that involves the removal of all lymph node groups from levels I through V, along with several non-lymphatic structures.
- The internal jugular vein,
- sternomastoid muscle,
- spinal accessory nerve, and
- submandibular salivary gland are all sacrificed during this procedure to ensure complete removal of potential cancer-containing tissues. The posterior belly of the digastric muscle is preserved because it serves as an important anatomical landmark and its removal is not necessary for oncological clearance, as noted in the context of neck dissections 1. This muscle helps maintain some functional integrity in the neck region post-surgery. Modern approaches have evolved toward more selective neck dissections that preserve more structures when oncologically safe, but in a true radical neck dissection, the posterior belly of the digastric muscle is the only structure among those listed that is routinely preserved, based on the principles outlined for neck dissections in the management of head and neck cancers 1.
From the Research
Radical Neck Dissection
- The structures preserved in radical neck dissection are not explicitly stated in the provided study 2.
Structures Removed in Radical Neck Dissection
- According to the study, Martin's technique of radical neck dissection involves resection of:
- All lymph nodes from level I-V
- The accessory nerve
- Internal jugular vein
- Sternocleidomastoid muscle
- Various other structures in a single block of resected tissue 2
Modified Radical Neck Dissection
- In contrast, modified radical neck dissection preserves important structures, such as:
- Internal jugular vein
- Sternocleidomastoid muscle
- Accessory nerve 2
Answer to the Question
- Based on the information provided, the correct answer is:
- (e) posterior belly of the digastric muscle is not mentioned as being removed in radical neck dissection, however the study does not explicitly state which structures are preserved in radical neck dissection.
- The study does mention that the internal jugular vein, sternocleidomastoid muscle, and accessory nerve are removed in radical neck dissection, but preserved in modified radical neck dissection 2.