Neck Dissection of Level IIb: Is it Really Necessary?

Objectives: To determine whether resection of level IIb is necessary in elective or therapeutic neck dissections. Study Design: Prospective case series. Methods: Level IIb nodes were analyzed for micrometastases as separate specimens in 160 neck dissections on 148 patients with squamous cell carcino...

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Bibliographic Details
Published in:The Laryngoscope 2005-09, Vol.115 (9), p.1624-1626
Main Authors: Corlette, Toby H., Cole, Ian E., Albsoul, Nader, Ayyash, Mohammad
Format: Article
Language:English
Subjects:
Accessory Nerve Injuries
Adult
Aged
Biological and medical sciences
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Elective Surgical Procedures
Head and neck
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
Humans
level 2
level 2b
level II
level IIb
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Medical sciences
metastasis
Middle Aged
neck dissection
Neck Dissection - adverse effects
Neck Dissection - methods
nerve palsy
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Otorhinolaryngology. Stomatology
Parotid Neoplasms - surgery
Prospective Studies
selective neck dissection
shoulder
shoulder syndrome
Skin Neoplasms - surgery
spinal accessory nerve
squamous cell carcinoma
surgery
upper aerodigestive tract
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Summary:Objectives: To determine whether resection of level IIb is necessary in elective or therapeutic neck dissections. Study Design: Prospective case series. Methods: Level IIb nodes were analyzed for micrometastases as separate specimens in 160 neck dissections on 148 patients with squamous cell carcinoma of the head and neck. Results: In 106 elective neck dissections (N0 necks) from upper aerodigestive tract (UADT) and skin/parotid squamous carcinoma primaries, level IIb was involved in 4.5% and 33%, respectively. In 54 therapeutic neck dissections (N+ necks) from UADT and skin/parotid squamous carcinoma primaries, level IIb was involved in 25% and 71%, respectively. Apart from skin/parotid squamous carcinoma primaries, level IIb was never involved unless level IIa was also involved. Conclusions: Level IIb nodes can be left in situ in UADT primary carcinomas in nontonsillar N0 necks without significantly compromising regional clearance of micrometastases.
ISSN:0023-852X
1531-4995
DOI:10.1097/01.mlg.0000173154.92581.c5