Edward Nguyen - Oral and Maxillofacial Surgeon

Edward Nguyen - Oral and Maxillofacial Surgeon Consulting in Springvale, Footscray and Docklands

Services include removal of wisdom teeth, surgical extractions, dental implants, corrective jaw surgery, oral cancer, salivary gland pathology and facial trauma

The neck is an incredible and complex nexus between the head and the body. The neurovascular structures are intricate bu...
07/05/2026

The neck is an incredible and complex nexus between the head and the body. The neurovascular structures are intricate but when handled with respect, they are robust, and where oncologically sound should be preserved.

Neck dissection is a routine part of head and neck cancer management. When performing a neck dissection, node-bearing tissue is removed to stage a patient for regional spread of cancer. Depending on the final histology and whether cancer is identified within any lymph nodes, this can influence treatment algorithms such as whether the patient would require adjuvant radiotherapy and possibly chemotherapy.

Elective neck dissection has been shown to provide a survival benefit of up to 15%.

Ultimately, the goal of surgery is to provide the patient with a chance of cure, improve survival but also to preserve function and quality of life.

As you can see here, all the important structures are preserved. Ansa cervicalis contributes to swallow function. The accessory nerve contributes to shoulder movement. The facial nerve (not annotated) provides facial movement. The hypoglossal nerve (not annotated) innervates the tongue. The neck muscles are kept intact to maintain bulk, symmetry and function. The carotid artery (deep to IJV) supplies the face and majority of the cerebral flow to the brain.

Here is the left neck after a I-IV neck dissection in the management of a left lateral tongue SCC.

This man had a branchial cleft cyst removed 15 years ago. Since then he’s developed recurrence with significant neck swe...
27/04/2026

This man had a branchial cleft cyst removed 15 years ago. Since then he’s developed recurrence with significant neck swelling and had annual which turned into 6 monthly and then 3 monthly aspirations.

One of the concerns with neck swelling in an older patient is that of malignancy, so whilst this was likely to be benign based on its history, this is always on my mind.

Branchial cleft cyst is a benign fluid-filled sac which is often associated with the 2nd branchial arch. This often correlates with a painless swelling in level 1 and 2 anterior to the SCM.

The definitive management for recurrent branchial cleft cyst is limited neck dissection. This was performed for this patient given the recurrent nature as well as the scarred tissue planes due to repeated needle aspirations. The key to minimizing recurrence like any tumour resection is to maintain the integrity of the mass without spillage. Fortunately the mass was contained and the final histology confirmed branchial cleft cyst with lymphoid hyperplasia.

The critical structures including the marginal mandibular (VII), accessory (XI) and hypoglossal (XII) nerves were preserved.

The nerve stimulator was used to confirm the facial nerve branch was intact - watch the lip twitching.

You can also see the chronic nature of this process has effaced the local anatomy. The digastric is displaced superiorly. The IJV is essentially non-existent with multiple smaller venous tributaries.

This is him 2 weeks post surgery.

Happy EasterThis young lady had a class III facial discrepancy with a significant asymmetry in the mandible. She had an ...
07/04/2026

Happy Easter

This young lady had a class III facial discrepancy with a significant asymmetry in the mandible.

She had an unfavorable occlusion leading to uneven wear and functional limitations. She was also self conscious of her chin asymmetry and prognathic mandible.

She underwent a bimaxillary osteotomy with the use of custom plates to optimize surgical accuracy, minimize operative time and ultimately improve patient outcomes.

A couple of intraoperative videos and photos for the keen few. You can also note the nicely locked in occlusion on the table.

This is her post deband, 6 months after surgery with a class I occlusion, increased incisal show, facial balance, improved nasal breathing and full sensation of the sensory nerves to her face.

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Springvale, VIC

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+61390203778

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