One-stage bilateral radical neck dissection; indications and technique.

Simultaneous bilateral radical neck dissection is an operation entailing acceptable risk if used in propertly selected cases. The procedure is indicated for patients with bilateral cervical lymph node metastases so situated that a two-stage radical neck dissection could not be done without cutting through cancer tissue. Such patients are those with intraoral or cervical visceral midline primary lesions or those in whom, either by direct extension or lymph node involvement, the submental and submaxillary triangles are solidly permeated with cancer. The operation is indicated only for cure; for prophylaxis or palliation, lesser or staged procedures would be more productive of better results with less morbidity and mortality.