Levels of the neck and classification of neck dissection and incisions

Neck dissection is a common procedure performed to remove lymph nodes in the neck that may contain cancer based on patterns of cervical metastases. Since the establishment of the radical neck dissection by Crile et al. in the early 20th century, modifications to this technique have been made. An understanding of lymphatic drainage patterns in the head and neck allowed for more limited dissections with reduced morbidity. This review discusses the history of neck dissection levels to its current accepted classification by the American Head and Neck Society, the evolving types of neck dissections, and different incisions used to optimize resection and cosmetic outcomes.