GuidetoNeckDissection.pdf

Marco Lucioni

Practical Guide to Neck Dissection

Marco Lucioni

Practical Guide

to Neck Dissection

Forewords by

Italo Seraini, Jatin P. Shah, Jesus Medina,

Wolfgang Steiner, Antonio Antonelli

With 135 Figures, Mostly in Colour

123

Marco Lucioni, MD

Via G. Leopardi 9

31029 Vittorio Veneto, Italy

Library of Congress Control Number: 2007924718

ISBN 978-3-540-71638-9 Springer Berlin Heidelberg NewYork

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Foreword (I)

It was three o’ clock in the aternoon: time for

anatomy class. A badly lit room, a caretaker to

collect tips, and a single lecturer for 30 students.

he material on which to study practical anat-

omy consisted of a humerus, a femur, and an en-

tire decomposing human forearm with skeletized

muscles and tendons, reduced to shreds by previ-

ous inexperienced dissectors. hen, 2 years later

at midday, I found myself in a pathologic anat-

omy amphitheater with 300 students. An empty

corpse lay on the distant dissection table with

various removed organs lined up by its side. he

lecturer was giving his last class for the course

and gratefully addressed the deceased, “for do-

nating his body to the progress of science”. hese

are my recollections as a student of medicine 35

years ago. Yet Padua was an important University,

one of the most ancient, most prestigious univer-

sities in Europe! hese experiences go back many

years, but I do believe the situation has changed

very little since then.

hese were my thoughts 15 years ago when

I was invited to direct a neck dissection course

in the corpse at the Vrije Universiteit Brussel. To

prepare the course, ater 30 years’ experience in

neck surgery, I went back to, or rather, I found

myself for the very irst time dissecting a cadaver.

I would like to thank all colleagues at the Uni-

versity of Pavia for lending me their dissection

theater. It was a stimulating, highly positive expe-

rience, enabling my coworker and me to broaden

and develop our knowledge of neck anatomy

and its border areas. While we iconographically

documented the various cervical regions and dis-

section planes, our thoughts turned to past expe-

riences in this type of activity.

Anatomic dissection for research purposes

dates back to the Egyptians in Alexandria, but

was prohibited in the Western world for many

centuries by Jewish and Christian religious cul-

ture. A decree was passed in the Kingdom of

Sicily in 1231 by Frederick II of Swabia, stating

that “… all those who studied surgery should be-

come learned in operations and particularly in

the anatomy of the human body …” Mondino dei

Liuzzi, author in 1316 of the treatise Anathomia,

introduced cadaveric dissection into the univer-

sity teaching curriculum in Bologna. he chief

Council of the Serenissima Republic in Venice

decreed that every year a number of corpses

should be dissected “propter urbis honorem civi-

umque salutem”.

However, the “anatomy century” was un-

doubtedly the 16th century, with its Renaissance

anatomists. he most outstanding igure in the

scientiic revolution of that period was clearly

Andreas Vesalius from Brussels (1514–1564)

with his De Humani Corporis Fabrica. Prevented

from practicing dissection at the University of

Leuven, Vesalius came to Padua where, despite

his very young age, the Serenissima government

appointed him to the chair of anatomy in virtue

of his extensive knowledge on the subject and

corpse-dissecting skills.

Five and a half centuries later, we were to

make the same journey as Vesalius, only in the

opposite direction. Prevented by law and custom

from holding a course on dissection in Italy, we

let the land of the Serenissima in the direction

of Brussels, where a modern university organiza-

tion provided us with all the necessary technical

equipment and 15 cadavers. We armed ourselves

with our long and inveterate experience in neck

surgery and our more recent know-how in ca-

daveric neck dissection with related iconography.

When, ater the second “Andreas Vesalius course”,

as we call them, Dr. Marco Lucioni, my faithful

coworker in the preparation and conduction of

these scientiic-teaching ventures, expressed the

desire to produce a volume on anatomic neck

dissection techniques, based on our experience,

I did not hesitate to encourage him. I then enthu-

siastically observed the text being drawn up and

divided into the various chapters and igures.

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