Sixty-three patients underwent bilateral radical neck dissection for control of tumors of the head and neck. Two operative deaths occurred for a mortality of 1.5 per cent per procedure. Complications occurred in 45 per cent and related primarily to the procedure performed in conjunction with radical neck dissection. The high incidence of facial deformity and cerebrovascular complications described in other reports after bilateral radical neck dissection was not seen in this group. The three and five year survival percentages for the group as a whole were 44 and 32 per cent, respectively. Patients without histologic involvement of cervical nodes had three and five year survival rates of 60 and 48 per cent, respectively, whereas in those with nodal involvement three and five year survival fell to 43 and 28 per cent, respectively. The review of our experience has led to the following conclusions: 1. 1. Bilateral radical neck dissection is both an effective and feasible weapon in the control of tumors of the head and neck. 2. 2. A high incidence of relatively minor complications can be expected and relates directly to the procedure performed in conjunction with radical neck dissection. The operative death rate of 3.0 per cent and the low incidence of facial deformity and cerebrovascular complications is well within acceptable limits. 3. 3. The presence of histologic involvement of nonpalpable cervical lymph nodes lends support to those who advocate prophylactic neck dissection. 4. 4. The increased survival seen in the patients who had a second neck dissection during the initial hospitalization period, before palpable cervical nodes developed, lends further evidence that prophylactic neck dissection is of benefit in patients with aggressive lesions of the head and neck. 5. 5. With both the low operative mortality and prolonged survival offered many patients, bilateral radical neck dissection should be employed more frequently in control of tumors of the head and neck. © 1969.
