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How we do it: a method of neck dissection for histopathological analysis

Tahwinder Upile1234*, Waseem Jerjes456, Seyed Ahmad Reza Nouraei2, Sandeep Singh1, Peter Clarke2, Peter Rhys-Evans7, Colin Hopper456, David Howard2, Anthony Wright3, Holger Sudhoff8, Cyril Fisher9 and Ann Sandison10

Author affiliations

1 The Ear Institute, University College London, London, UK

2 Department of Head & Neck Surgery, Charing Cross Hospital, UK

3 Department of Head & Neck Surgery, The Professorial Unit, The Royal National Throat, Nose and Ear Hospital, London, UK

4 Oral & Maxillofacial Surgery/Head & Neck Unit, University College London Hospital, London, UK

5 Department of Surgery, Royal Free & University College Medical School, London, UK

6 Unit of Oral & Maxillofacial Surgery, Division of Maxillofacial, Diagnostic, Medical and Surgical Sciences, UCL Eastman Dental Institute, London, UK

7 Department of Head & Neck Surgery, The Royal Marsden Hospital, London, UK

8 Department of Otorhinolaryngology, University of Bochum, Germany

9 Department of Histopathology, The Royal Marsden Hospital, London, UK

10 Department of Pathology, Charing Cross Hospital, London, UK

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Citation and License

BMC Surgery 2007, 7:21  doi:10.1186/1471-2482-7-21

Published: 31 October 2007



Dissection of the lymphatic structures in the neck is an integral part of the management of many head and neck cancers.

We describe a technique of surgical dissection, preparing the tissue for more precise histological analysis while also reducing operative time and complexity.


When dissected, each level is excised between lymph nodes groups and put into a separate pot of formalin taking care to avoid rupture of any obvious pathological nodes.


This makes for a simpler dissection as the surgeon progresses, as a larger more cumbersome specimen is avoided and manipulation of involved nodes is actually reduced with a reduced risk of tumour spillage.


We feel that our technique provides several advantages for the histopathologist as well as the surgeon. As the dissection of the specimen into the relevant levels has already been performed, time is saved in orientating and then dissecting the specimen. Accuracy of dissection is also improved and each piece of tissue is a more manageable size for processing and analysis.

This technique may also have several surgical advantages when compared with the commonly practiced techniques e.g. with reducing in-vivo specimen manipulation, hence reducing the risk of inadvertent injury to important structures and tumour spillage.