在20世纪以前,头颈部癌瘤的外科治疗常常失败,其原因之一是癌瘤沿淋巴系扩散。Butlin曾指出,区域淋巴结受累的重要意义,舌癌更为如此。Crile设计了解决区域淋巴结转移的手术方法,从而使头颈部癌的外科治疗处于合理的地位;此后,颈淋巴结根治性清除术才有了统一的认识。为了减少该手术的并发症和死亡率,曾对此手术进行了多次修正。Semken提出对于临床上未摸到颈部淋巴结者,可对头颈部的原发灶与颈清除术分期进行;其他人也提 Before the 20th century, surgical treatment of head and neck cancers often failed. One of the reasons for this was the spread of cancer along the lymphatic system. Butlin pointed out that the importance of regional lymph node involvement is even more so with tongue cancer. Crile designed a surgical approach to resolve regional lymph node metastases so that surgical treatment of head and neck cancers is in a reasonable position; thereafter, a radical understanding of radical lymph node dissection has been achieved. In order to reduce the complications and mortality of this operation, several modifications have been made to this operation. Semken proposed that for patients with cervical lymph nodes that are clinically untouched, the primary tumor and neck debridement of the head and neck can be staged; others also mention