Lateral Neck Dissection: Indications and Technique

Abstract The incidence of thyroid cancer has been increasing over the past few decades, and although the majority of cases are localized to the thyroid, the number of patients with lateral neck disease at first presentation has increased. Although an abundance of literature exists about the patterns of metastasis for thyroid carcinoma, some controversy remains surrounding the extent of neck dissection in patients who have suspicious or confirmed metastasis to the lateral neck. However, there is near universal agreement that lateral neck dissection for metastatic thyroid cancer should follow principles of compartment-based neck dissection with resection of involved and at-risk neck levels, most commonly a level II through VB selective lateral neck dissection. This chapter will address the indications and considerations of a lateral neck dissection for thyroid cancer, followed by the surgical approach for an oncologic resection of lateral neck disease.