Charles J. Staley

A muscle cover for the carotid artery after radical neck dissection

Abstract A modification of the conventional radical neck dissection is described in which the levator scapulae muscle is transplanted to provide a protective sheath for the carotid artery. It is hoped that this maneuver will eliminate the occasional hemorrhage which follows extensive surgery in the neck. It has been accomplished in only twelve instances and is not considered a procedure of established value. Additional experience is needed before final evaluation can be made.

Leiomyosarcoma of the inferior vena cava

Abstract Judging by the number of reported cases, leiomyosarcoma of the inferior vena cava is an exceedingly rare neoplasm. Tumors of smooth muscle origin are, however, the most common primary neoplasms of major veins, and the inferior vena cava is the most common site of origin. The clinical manifestations are governed by the location of the tumor and the presence or absence of obstruction of the vena cava and/or its tributaries. Chiaris syndrome is frequently produced. The eighteenth recorded instance of leiomyosarcoma of the inferior vena cava is presented. The patient, the fourth to undergo surgical removal of the tumor, is living and free of apparent disease one year later. All but two of the patients with previously recorded cases were dead at the time of this report, and in both of these patients there was recurrence after surgical removal.

Bilateral radical neck dissection

Abstract The management of the patient with bilateral metastases to the cervical lymph nodes has been discussed. Nine patients were subjected to complete bilateral radical neck dissection, four of which were performed in one stage, without operative mortality or serious postoperative morbidity. No significant complications attributable to venous engorgement or increased pressure of the cerebrospinal fluid have been noted. Simultaneous bilateral radical neck dissection is a procedure of limited applicability, but is fully justified in selected patients with potentially curable bilateral metastases to the cervical lymph nodes.