Oncological safety of the Hayes-Martin manoeuvre in neck dissections for node-positive oropharyngeal squamous cell carcinoma

The Hayes-Martin manoeuvre involves ligation of the posterior facial vein and superior reflection of the investing fascia below the mandible to preserve the marginal mandibular nerve. The peri-facial nodes thus remain undissected. We perform this manoeuvre routinely during modified radical neck diss...

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Bibliographic Details
Published in:Journal of laryngology and otology 2012-10, Vol.126 (10), p.1045-1048
Main Authors: Riffat, F, Buchanan, M A, Mahrous, A K, Fish, B M, Jani, P
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cancer
Carcinoma, Squamous Cell - secondary
Carcinoma, Squamous Cell - surgery
Dissection
Female
Humans
Lymphatic Metastasis
Main Articles
Male
Medical sciences
Metastasis
Middle Aged
Neck
Neck Dissection - adverse effects
Neck Dissection - methods
Oropharyngeal Neoplasms - surgery
Otorhinolaryngology. Stomatology
Radiation therapy
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:The Hayes-Martin manoeuvre involves ligation of the posterior facial vein and superior reflection of the investing fascia below the mandible to preserve the marginal mandibular nerve. The peri-facial nodes thus remain undissected. We perform this manoeuvre routinely during modified radical neck dissection for metastatic oropharyngeal squamous cell cancer. Here, we review the oncological safety and marginal mandibular nerve preservation rates of this manoeuvre from 2004 to 2009. Retrospective review of the head and neck oncology database (2004-2009) at Addenbrooke's Hospital, Cambridge, UK, a tertiary referral centre for head and neck oncology. Thirty-four patients underwent modified radical neck dissection for metastatic oropharyngeal squamous cell carcinoma. The primary tumour included the tonsil in 19 cases, base of tongue in 10 and posterior pharyngeal wall in 5. The neck nodal status was N1 in 4 cases, N(2a) in 11, N(2b) in 10, N(2c) in 4 and N(3) in 5. All patients had adjuvant radiotherapy. Median follow up was four years (range, two to five). No peri-facial nodal region recurrences were seen. Four patients had temporary marginal mandibular nerve weakness; beyond two months, no weakness was seen. In neck dissections for oropharyngeal squamous cell carcinoma, the marginal mandibular nerve and accompanying facial nodes can be safely preserved without oncological risk using the Hayes-Martin manoeuvre.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215112001740