The fundamental logic of a regional node dissection accompanying the removal of a primary malignant epithelial tumor has been almost universally accepted since the turn of the 20th century. Progressively, as the technical aspects mitigating against its application have been removed, the principle has been applied in the optimal management of an increasing number of such lesions.
The treatment of intraoral cancer anatomically lends itself well to such a surgical approach. Furthermore, since over 80% of the patients with intraoral cancer who succumb to their disease do so with the cancer localized in the regional area rather than complicated by hematogenous dissemination, there is additional impetus toward such en bloc dissection. For numerous reasons, not the least of which was infection and its associated morbidity, discontinuity procedures generally had been accepted and employed. However, even with the advent of antibiotics and other supportive measures, the authors, as well as many