الفهرس 
Anatomy of cervical lymph nodesOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
One of the most important prognostic factors in head and neck cancer is the presence or absence, level and size of metastatic neck disease (Watkinson et al, 1991).
In spite of advancement in science, molecular medicine and target therapies, surgical treatment of metastases using different techniques, from selective neck dissection to extended radical neck dissections, form a major part in the management of neck metastases. This is due to the fact that, so far, there is no treatment more effective for resectable neck metastases (Subramanian et al, 1994).
Modified radical neck dissection (MRND) is associated with less cosmetic and functional morbidity than RND but, used alone, MRND is only appropriate when clinical neck disease is absent or minimal (O’Brien et al, 1987).
Radical neck dissection removes the lymph node containing levels in neck (I-V), and all the three non lymphatic structures (spinal accessory nerve, sternomastoid muscle and the internal jugular vein) Modified radical neck dissection remove all lymph nodes groups (levels I-V) with preservation of one or more non lymphatic structures.
Type 1 – Modified radical neck dissection preserve spinal accessory nerve
Type 2 – Preserves not only the spinal accessory nerve but also the internal jugular vein.
Type 3 – Dissection preserve spinal accessory nerve, the internal jugular vein and sternomastoid muscle (Watkinson et al, 1991).
In the presence of clinically positive nodal metastasis, the benefit of preserving the spinal accessory nerve (SAN) has to be weighed against the possible risk of increased failure in the neck. (Andersen., al 1994).
This meta-analytic study was performed to know which of the two approaches Modified radical neck dissection or Radical neck dissection is better to improve survival in patient with cervical N+ squamous cell carcinoma of head and neck.
This was done through the following steps:
Target: Does modified radical neck dissection is better than radical neck dissection in the survival of patient with cervical N+ squamous cell carcinoma of head and neck.
Identification and location of articles: By searching in the pub-med where 196 articles where found 58 of them were relevant to our study.
Screening and evaluation: According to the inclusion criteria, 7 articles were included and 138 articles were excluded.
Data collection: Through the 7 included articles.
Data analysis:
Data analysis was performed utilizing Meta-analytic Review Manger (Rev-Man 5) software. The results of the data collected from the chosen articles were fed into the above mentioned (Rev-Man 5) software.
Reporting and Interpretation of results:
Our study analyzing 7 articles studying 2495 patients with metastatic neck disease in which 1018 received MRND therapy alone or in combination with chemotherapy and 1477 patients received RND (control). Were 120 out of 1018 patients received MRND shows regional recurrence, while 181 out of 1477 patients received RND (control group) shows regional recurrence.
- The results show an insignificant difference between patients receiving MRND and patients receiving RND.
- This systematic review from which there was no evidence that Radical neck dissection (RND) had a superior result than Modified radical neck dissection (MRND) in locoregional control.
- MRND therapy has less morbidity than RND.
The prognosis depends on various factors, such as stage, age, degree of differentiation.