Selective dissection of levels II-III with intraoperative control of the upper and middle jugular nodes: A therapeutic option for the no neck

Xavier León, Miquel Quer, César Orús, Francisco José Sancho, Silvia Bagué, Joaquim Burgués

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44 Citations (Scopus)

Abstract

Background. Selective neck dissections are accepted elective treatment in NO patients. We present the results of a dissection of levels II to III and intraoperative pathologic control of a sample of subdigastric and supraomohyoid nodes in a group of patients with laryngeal carcinoma. When intraoperative analysis was positive, dissection of levels IV and V was completed. Methods. Between 1991 and 1997, 145 neck dissections with intraoperative control were carried out in 79 patients with laryngeal carcinomas. Postoperative radiotherapy was used in 49 patients. Results. There were occult metastases in 29 neck dissections (20%). In 22 cases (15%), tumor was found in the nodes sent to intraoperative pathologic study, and dissection of levels IV and V was completed. In 7 additional cases tumor was found in the postoperative study. The sensitivity of the use of frozen sections in the detection of occult metastases was 76%. In no case were positive nodes found at level V. There was no regional relapse in any of the 145 selective neck dissections. Conclusions. The lateral selective neck dissection is an effective method in the elective treatment of the neck of NO laryngeal carcinoma patients. Dissection of level IV can be spared when intraoperative biopsy specimens of a sample of the subdigastric and supraomohyoid nodes are negative. According to our results, at present we do not consider it necessary to dissect level V in selective neck dissections in patients with laryngeal carcinoma. © 2001 John Wiley & Sons, Inc.
Original languageEnglish
Pages (from-to)441-446
JournalHead and Neck
Volume23
DOIs
Publication statusPublished - 11 Jun 2001

Keywords

  • Laryngeal carcinoma
  • Neck dissection
  • Neck nodes
  • Selective neck dissection

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