Management of the N0 neck

Published on March 30, 2017   49 min

Other Talks in the Series: Oral & Maxillofacial Medicine

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Hello, and welcome to a lecture on the Management of the N0 Neck. My name is Peter Brennan. I'm a Consultant Maxillofacial surgeon, working at the Queen Alexandra Hospital in Portsmouth, UK. And also, I have extensive experience as a surgeon treating about 50 to 60 head and neck cancer patients per year, including many neck dissections, and as an honorary chair, I have written about 400 papers, many in the head and neck involving controversies. And hopefully, this will be a simplified talk about how to manage the N0 neck, which is a controversial subject. There's lots in the literature both for neck dissection and for observation. I've tried to simplify the talk, and hopefully at the end, you'll have an understanding of how to manage the clinically N0 neck.
I think it's worth saying that for every single head and neck cancer patient that we treat, it's important to discuss the management of every cancer patient in the head and neck multidisciplinary team. And here, you can see a slide of us sitting in the team meeting. You can see a CT-scan up on the screen, and in fact if you look on the left neck, you can see a very sizable lymph node behind the left mandible there. Every case is discussed by the team. There's a radiologist as you can see at the front presenting the imaging. We have a pathologist. There will be oncologists, radiotherapists, palliative care people, speech and language therapists, dieticians, a number of surgeons both in ENT and oral and maxillofacial surgery. And so as a group, we will discuss every single patient and the best management for that patient whether that be surgery, radiotherapy, a combination of both, or sometimes palliative care, of course, as well.