How we do it: a method of neck dissection for histopathological analysis

We describe a technique of surgical dissection, preparing the tissue for more precise histological analysis while also reducing operative time and complexity.When dissected, each level is excised between lymph nodes groups and put into a separate pot of formalin taking care to avoid rupture of any obvious pathological nodes.This makes for a simpler dissection as the surgeon progresses, as a larger more cumbersome specimen is avoided and manipulation of involved nodes is actually reduced with a reduced risk of tumour spillage.We feel that our technique provides several advantages for the histopathologist as well as the surgeon. As the dissection of the specimen into the relevant levels has already been performed, time is saved in orientating and then dissecting the specimen. Accuracy of dissection is also improved and each piece of tissue is a more manageable size for processing and analysis.This technique may also have several surgical advantages when compared with the commonly practiced techniques e.g. with reducing in-vivo specimen manipulation, hence reducing the risk of inadvertent injury to important structures and tumour spillage.A neck dissection specimen when removed "en bloc" (radical neck dissection) and preserved in formalin may be unrecognisable when processed by the histopathology laboratory. Even when labelled or pinned on cork board (orientation plate), the boundaries of the levels of lymph nodes within the neck are surgical boundaries not easy to delineated in the resected specimen. Considering that up to 30% formalin-related post-excision shrinkage may occur, any labelling technique has to be able to withstand the vagaries of processing.This is more so with the increasing use of the modified radical (selective) neck dissection were preservation of the internal jugular vein and the sternocleidomastiod (SCM) and functional neck dissection further increase the difficulty of orientating the specimen.Correct and accurate analysis of the lymph nodes surgi