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Treatment of Carcinoma of the Tongue:  End-Results in One Hundred Sixty-Eight Cases

OLIVER H. BEAHRS, M.D.; KENNETH D. DEVINE, M.D.; STANLEY W. HENSON, M.D.
AMA Arch Surg. 1959;79(3):399-403. doi:10.1001/archsurg.1959.04320090047007.
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Radical dissection of the neck as part of the definitive treatment of malignant lesions about the head and neck was first advocated by George Crile Sr.1,2 Previously, many surgeons reported the removal of cervical lymph nodes in the course of operations for carcinoma of the oral cavity, but none saw so clearly as he did the importance of removing completely the cervical lymphatics. Crile had the foresight to interpret accurately the data available to him and to present a planned procedure comparable to those attributed to Halsted and Miles, which were designed to remove the regional lymphatics along with the primary lesion. He advocated combined procedures that removed the floor of the mouth and tongue in combination with dissection of the neck. He proposed and practiced excision of the sternocleidomastoid and omohyoid muscles, the internal jugular vein, and all the areolar and lymphatic tissues of the neck. His operation,

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