Two Approaches to Level 5 Neck Dissection

  • Lymph node metastasis to the lateral neck in papillary thyroid cancer can occur in upwards of 60% of patients. Moreover, metastasis to level V can occur in 13 – 20% of patients with lateral neck disease, particularly if there is disease in levels II – IV, making a level V dissection important in the surgical treatment of regionally metastatic papillary thyroid cancer. Here we present a video demonstrating two surgical techniques to dissect level V. First, we describe an anterior approach well suited for patients who do not have clinically evident or have low volume disease in level V. Alternatively, we describe a posterior (traditional) approach to level V for bulkier disease or as body habitus necessitates. Both techniques, when applied in the appropriate clinical scenario, provide appropriate clearance of level V.


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