Lateral Neck Dissection: Indications and Technique

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

“…42,43 Against the backdrop of hitherto unforeseen resource constraints and the potential for viral transmission, novel methods of head and neck cancer service delivery needed to be developed. Frameworks, protocols, and consensus statements from leading academic centers [44][45][46][47][48][49] and professional organizations provided recommendations for head and neck cancer surgical, 50 radiation, 51,52 and medical oncologic care. 53 Although diverse in scope, these recommendations shared a common thread of attempting to develop novel care delivery strategies that recognized the oncologic importance of delivering timely treatment that adheres to evidence-based standards of care amid new capacity limitations.…”

“…44 In general, two triage strategies emerged: (1) general frameworks and (2) prioritization algorithms. General prioritization frameworks were preferred by some because they facilitate case-by-case decisionmaking and allow for flexibility and the use of clinical judgment, 45 whereas others favored prioritization algorithms to minimize the logistical challenges, cognitive burden, and inherent bias associated with case-by-case, frameworkbased decision-making. 83 Numerous frameworks for ethically triaging and prioritizing head and neck cancer care during the COVID-19 pandemic in the United States were developed from leading academic institutions.…”

“…83 Numerous frameworks for ethically triaging and prioritizing head and neck cancer care during the COVID-19 pandemic in the United States were developed from leading academic institutions. [44][45][46][47][48][49] These frameworks focused on a number of variables, including the acuity and risk of treatment delay, expected oncologic outcomes, risk of viral transmission during surgery, availability of supportive resources, and safety of health care personnel. To help minimize variability and confusion for providers stemming from the massive number of triage frameworks, an international consensus statement from 35 interprofessional societies was developed to help prioritize surgical care for patients with head and neck cancer.…”