For many years, the presence of bilateral cervical metastatic lesions secondary to labial, intraoral, or laryngeal carcinoma made the condition inoperable, and, in the absence of other definitive therapeutic agents, incurable. Cervical metastatic tumors have not, in general, been amenable to radiation therapy. Bilateral sacrifice of the internal jugular veins was thought by most surgeons and anatomists to be a fatal procedure. As a result, when Evans1 reviewed this subject in 1942, he was able to find reports of only 7 cases in which bilateral interruption of the internal jugular veins had been done by general surgeons. In these 7 instances, 3 patients died after operation, 3 survived, and the fate of 1 was unknown. More recently, many anatomic and surgical reports have shown that bilateral sacrifice of the internal jugular veins can be done safely without jeopardy to the patient.2-5 The clinical adequacy of the remaining venous network