The history of Crile’s neck dissection
Nikolaos Lazaridis
Emeritus Professor, Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki
Hellenic Archives of Oral & Maxillofacial Surgery (2022) 1, 5-24
DOI https://dx.doi.org/10.54936/haoms231524
The four “giants” of late 19th century, von Langenbeck, Kocher, Packard and Butlin developed and reported their early cases of different types of neck dissection. Butlin in England conceived and developed the concept of selective neck dissection. In 1888, Polish surgeon Jawdynski reported and described in detail the first successful extended en bloc neck dissection. In 1905 and 1906, an American surgeon Crile based on his experience in treatment of head and neck cancer and after having treated a large number of cases, reached the conclusion that head and neck tumors almost always drain through lymphatic pathways of the neck and rarely metastasize distantly. These tumors could be consequently successfully treated by resection of the primary tumor and its lymphatic draining shed. Crile found out that an en bloc resection of all lymph node-bearing tissue of the neck in addition to resection of the primary tumor was the most effective mean of obtaining a cure, particularly in patients with clinical evidence of spread of the disease to the neck. Such radical surgery at that time was fraught with difficulty because of lack of blood transfusion, antibiotics and endotracheal anesthesia. Crile developed several strategies for combating these obstacles. He performed 26 such block resections and obtained a 3-year survival of 75%, compared to 19% 3- year survival in patients who had not undergone block resection. The operative principles developed by Crile led to a worldwide acknowledgement of this procedure as an effective operation that any trained surgeon could perform with reproducible results.
Key words: radical neck dissection, oral carcinoma, neck dissection, Crile.
REFERENCESButlin HT. Diseases of the Tongue. London: Cassell &Co.; 1885.
Carrau RL, Snyderman C, Janecka IP, Sekhar L, Sen C, D'Amico F. Antibiotic prophylaxis in cranial base surgery. Head Neck. 1991;13(4):311-317.
Crile GW. On the surgical treatment of cancer of head and neck. With a summary of one hundred and twenty-one operations performed upon one hundred and five patients. Trans South Surg Gynecol Assoc 1905;18:108-127.
Dickinson K, Roberts I. MAST for circulatory support in patients with trauma. The Cochrane Library; 2001.
Ferlito A, Rinaldo A, Silver CE, et al. Neck dissection: then and now. Auris Nasus Larynx. 2006;33(4):365-374.
Folz BJ, Ferlito A, Silver CE, et al. Neck dissection in the nineteenth century. Eur Arch Otorhinolaryngol. 2007;264(5):455-460. doi:10.1007/s00405-007-0261-9.
Grile GW. Excision of cancer of the head and neck. With special reference for the plan of dissection based on one hundred and thirty-two operations. JAMA 1906;47:1780-1786.
Halsted WS. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to January 1894. Johns Hopkins Hospital Reports. 1894–1895; 4:297–350.
Jawdynski F. Przypadek raka pierwotnego szyi. T.z. raka skrzelowego Volkmann’a. Wyciecie nowotworu wraz z rezekcyja tetnicy szyjowej wspolnej I zyly szyjowej wewnetrznej. Wyzdrowienie. Gaz Lek 1888;8:530-7.
Kaplan BC, Civetti JM, Nagel EL, Nagel EL, Nussenfeld SR, Hirschman JC. The military anti-shock trouser in civilian pre hospital care. J Trauma. 1973;13:843–8.
Kierzek A. Otolaryngologia warszawska w koncu XIX I na poczatku XX wieku. Otolaryngol Pol 2003;57:761-764.
Kocher T. Ueber Radicalheilung des Krebses. Dtsch Z Chir 1880;13:134-66.
Langenbeck B. Totalextripation des Kehlkopfes mit dem Zungenbein, einem Theil der Zunge, des Pharynx und Oesophagus. Berl Klin Wschr 1876;12:33.
Lore JM, Medina J: An Atlas of Head & Neck Surgery, 4th edition, Saunders, 2004.
Martin HE., Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer 1951;4:441-99.
Martis Ch. Case for ligation of the external carotid artery in composite operation of oral carcinoma. Int. J. Oral Surg. 7, 95, 1978a.
Martis Ch., Karakasis D. Prophylactic neck dissection in oral carcinoma. Int. J. Oral Surg 1974;3:293.
Martis Ch., Lazaridis N., Karabouta Ir. The internal carotid artery in the surgery of the extensive oral cancer Quintessense. 6,22, 1985.
McGregor I., Howard D.: Head and Neck (part 2) 4th edition, Rob&Smith’s Operative Surgery Series, CRC Press, 1998.
Schwab CW, Gore D. MAST: Medical anti-shock trousers. Surg Annu. 1983;15:41–59.
Silver, C.E., Rinaldo, A. and Ferlito, A. (2007), Crile's Neck Dissection. The Laryngoscope, 117: 1974-1977.
Towpik E. Centennial of the first description of the en bloc neck dissection. Plast Reconstr Surg 1990;85;468-470.
Volkmann R. Das tiefe branchiogene Halskarcinom. Zeentralbl Chir 1882;9:49-51.
Γιαννουλόπουλος Α.: Παρατηρήσεις επί της χειρουργικής επεμβάσεως της ριζικής λεμφογαγγλιακής εκτομής του τραχήλου επί της στοματικής κοιλότητας. Οδοντιατρική 1978; 11:299.
Ζαμπάκος Η.: Κακοήθη νεοπλάσματος στόματος. Εις: Λουκόπουλος Ν.: Γναθοπροσωπική Χειρουργική 1984, σελ. 783.
Καρακάσης Δ.Θ., Λαζαρίδης Ν.Θ.: Στοματική και Γναθοπροσωπική Χειρουργική, Εκδόσεις ΑΘΑΝΑΣΙΟΥ ΑΛΤΙΝΤΖΗ, Θεσσαλονίκη 2010.
Καρακάσης ΔΘ: Μαθήματα Οδοντογναθικής Χειρουργικής. Εκδ. Αλτιντζή, Θεσσαλονίκη, 1986, σελ. 112.
Λαζαρίδης Ν., Τηλαβερίδης Ι., Κομματά Α., Αντωνιάδης Β.: Η υπερωμοϋοειδής τραχηλική λεμφαδενεκτομή για την αντιμετώπιση του κλινικά αρνητικού τράχηλου (Ν0) ασθενών με καρκίνο στόματος. Ελλ. Π. Στομ. Γναθοπροσωπ. Χειρ. 1999; 14:81-91.
Μάρτης Χ.: Αι ριζικαί επί ενδοστοματικού καρκίνου χειρουργικαί επεμβάσεις. Στόμα 1974; 1:5.
Τριχίλης Ε.: Ριζικός λεμφαδενικός καθαρισμός τραχήλου. Εις Βασιλόπουλος Π., Τριχίλης Ε.: Όγκοι κεφαλής και τραχήλου, 1995, σελ. 203.
Emeritus Professor, Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki
Hellenic Archives of Oral & Maxillofacial Surgery (2022) 1, 5-24
DOI https://dx.doi.org/10.54936/haoms231524
The four “giants” of late 19th century, von Langenbeck, Kocher, Packard and Butlin developed and reported their early cases of different types of neck dissection. Butlin in England conceived and developed the concept of selective neck dissection. In 1888, Polish surgeon Jawdynski reported and described in detail the first successful extended en bloc neck dissection. In 1905 and 1906, an American surgeon Crile based on his experience in treatment of head and neck cancer and after having treated a large number of cases, reached the conclusion that head and neck tumors almost always drain through lymphatic pathways of the neck and rarely metastasize distantly. These tumors could be consequently successfully treated by resection of the primary tumor and its lymphatic draining shed. Crile found out that an en bloc resection of all lymph node-bearing tissue of the neck in addition to resection of the primary tumor was the most effective mean of obtaining a cure, particularly in patients with clinical evidence of spread of the disease to the neck. Such radical surgery at that time was fraught with difficulty because of lack of blood transfusion, antibiotics and endotracheal anesthesia. Crile developed several strategies for combating these obstacles. He performed 26 such block resections and obtained a 3-year survival of 75%, compared to 19% 3- year survival in patients who had not undergone block resection. The operative principles developed by Crile led to a worldwide acknowledgement of this procedure as an effective operation that any trained surgeon could perform with reproducible results.
Key words: radical neck dissection, oral carcinoma, neck dissection, Crile.
REFERENCESButlin HT. Diseases of the Tongue. London: Cassell &Co.; 1885.
Carrau RL, Snyderman C, Janecka IP, Sekhar L, Sen C, D'Amico F. Antibiotic prophylaxis in cranial base surgery. Head Neck. 1991;13(4):311-317.
Crile GW. On the surgical treatment of cancer of head and neck. With a summary of one hundred and twenty-one operations performed upon one hundred and five patients. Trans South Surg Gynecol Assoc 1905;18:108-127.
Dickinson K, Roberts I. MAST for circulatory support in patients with trauma. The Cochrane Library; 2001.
Ferlito A, Rinaldo A, Silver CE, et al. Neck dissection: then and now. Auris Nasus Larynx. 2006;33(4):365-374.
Folz BJ, Ferlito A, Silver CE, et al. Neck dissection in the nineteenth century. Eur Arch Otorhinolaryngol. 2007;264(5):455-460. doi:10.1007/s00405-007-0261-9.
Grile GW. Excision of cancer of the head and neck. With special reference for the plan of dissection based on one hundred and thirty-two operations. JAMA 1906;47:1780-1786.
Halsted WS. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to January 1894. Johns Hopkins Hospital Reports. 1894–1895; 4:297–350.
Jawdynski F. Przypadek raka pierwotnego szyi. T.z. raka skrzelowego Volkmann’a. Wyciecie nowotworu wraz z rezekcyja tetnicy szyjowej wspolnej I zyly szyjowej wewnetrznej. Wyzdrowienie. Gaz Lek 1888;8:530-7.
Kaplan BC, Civetti JM, Nagel EL, Nagel EL, Nussenfeld SR, Hirschman JC. The military anti-shock trouser in civilian pre hospital care. J Trauma. 1973;13:843–8.
Kierzek A. Otolaryngologia warszawska w koncu XIX I na poczatku XX wieku. Otolaryngol Pol 2003;57:761-764.
Kocher T. Ueber Radicalheilung des Krebses. Dtsch Z Chir 1880;13:134-66.
Langenbeck B. Totalextripation des Kehlkopfes mit dem Zungenbein, einem Theil der Zunge, des Pharynx und Oesophagus. Berl Klin Wschr 1876;12:33.
Lore JM, Medina J: An Atlas of Head & Neck Surgery, 4th edition, Saunders, 2004.
Martin HE., Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer 1951;4:441-99.
Martis Ch. Case for ligation of the external carotid artery in composite operation of oral carcinoma. Int. J. Oral Surg. 7, 95, 1978a.
Martis Ch., Karakasis D. Prophylactic neck dissection in oral carcinoma. Int. J. Oral Surg 1974;3:293.
Martis Ch., Lazaridis N., Karabouta Ir. The internal carotid artery in the surgery of the extensive oral cancer Quintessense. 6,22, 1985.
McGregor I., Howard D.: Head and Neck (part 2) 4th edition, Rob&Smith’s Operative Surgery Series, CRC Press, 1998.
Schwab CW, Gore D. MAST: Medical anti-shock trousers. Surg Annu. 1983;15:41–59.
Silver, C.E., Rinaldo, A. and Ferlito, A. (2007), Crile's Neck Dissection. The Laryngoscope, 117: 1974-1977.
Towpik E. Centennial of the first description of the en bloc neck dissection. Plast Reconstr Surg 1990;85;468-470.
Volkmann R. Das tiefe branchiogene Halskarcinom. Zeentralbl Chir 1882;9:49-51.
Γιαννουλόπουλος Α.: Παρατηρήσεις επί της χειρουργικής επεμβάσεως της ριζικής λεμφογαγγλιακής εκτομής του τραχήλου επί της στοματικής κοιλότητας. Οδοντιατρική 1978; 11:299.
Ζαμπάκος Η.: Κακοήθη νεοπλάσματος στόματος. Εις: Λουκόπουλος Ν.: Γναθοπροσωπική Χειρουργική 1984, σελ. 783.
Καρακάσης Δ.Θ., Λαζαρίδης Ν.Θ.: Στοματική και Γναθοπροσωπική Χειρουργική, Εκδόσεις ΑΘΑΝΑΣΙΟΥ ΑΛΤΙΝΤΖΗ, Θεσσαλονίκη 2010.
Καρακάσης ΔΘ: Μαθήματα Οδοντογναθικής Χειρουργικής. Εκδ. Αλτιντζή, Θεσσαλονίκη, 1986, σελ. 112.
Λαζαρίδης Ν., Τηλαβερίδης Ι., Κομματά Α., Αντωνιάδης Β.: Η υπερωμοϋοειδής τραχηλική λεμφαδενεκτομή για την αντιμετώπιση του κλινικά αρνητικού τράχηλου (Ν0) ασθενών με καρκίνο στόματος. Ελλ. Π. Στομ. Γναθοπροσωπ. Χειρ. 1999; 14:81-91.
Μάρτης Χ.: Αι ριζικαί επί ενδοστοματικού καρκίνου χειρουργικαί επεμβάσεις. Στόμα 1974; 1:5.
Τριχίλης Ε.: Ριζικός λεμφαδενικός καθαρισμός τραχήλου. Εις Βασιλόπουλος Π., Τριχίλης Ε.: Όγκοι κεφαλής και τραχήλου, 1995, σελ. 203.
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