Historical milestones in the evolution of the procedure of neck dissection.

Objective: Although neck dissection has evolved to become an integral part of the surgical armamentarium for managing head and neck cancers, the manner in which the procedure has reached its present state is worth revisiting. Data Sources: Published original articles, reviews, clinical practice guidelines, and consensus statements related to the basis, indication, and classification of the neck dissection. Methods: This review discusses some of the critical milestones before and after the description of the procedure of neck dissection by George Crile Sr. in 1905, which eventually played a role in the evolution of this commonly performed oncosurgical procedure. Results: Several large observational studies of the twentieth century and multicentric randomized trials at the turn of the twenty-first century have shaped neck dissection into a safe and reliable oncosurgical procedure. Conclusions: From being a radical surgery that was done mostly in large nodal diseases for curative or palliative purposes to becoming a simple procedure that is carried out even in node-negative cases of head and neck cancers for prognostic purposes, the procedure of neck dissection has come a long way and continues to evolve.