Supraomohyoid neck dissection

• Published in: The American journal of surgery 1996-12, Vol.172 (6), p.650-653
• Main Authors: Spiro, Ronald H., Morgan, Gary J., Strong, Elliot W., Shah, Jatin P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Dissection; Female; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Lymphatic Metastasis; Male; Medical sciences; Metastases; Middle Aged; Neck; Neoplasm Recurrence, Local; Neoplasm Staging; Oropharyngolaryngeal carcinoma; Radiation; Radiation therapy; Retrospective Studies; Squamous cell carcinoma; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(96)00300-5

Supraomohyoid neck dissection (SOHND) has assumed increasing importance as a staging lymphadenectomy in patients with N 0 oral and oropharyngeal squamous cell carcinoma (SCC), as well as a potentially curative procedure in selected patients with limited metastatic disease in the neck. Retrospective chart review of 287 patients who had a total of 320 SOHND for SCC between 1986 and 1993 as a follow-up to an earlier report that covered our experience between 1980 and 1985. After excluding 24 patients who also had local recurrence, or a new primary, the remaining 296 SOHND were assessed for the effectiveness of tumor control in the neck. Of 248 elective SOHND, clinically negative nodes proved histologically positive in 60 patients (25%), only 4 of whom failed in the neck (7%). A total of 48 patients (16%) had a therapeutic SOHND for limited N+ disease, confirmed pathologically in 31, with neck recurrence documented in 2 (6%). N 0des proved negative histologically in 205 patients, 10 of whom failed in the neck (5%). Nine of the 16 patients with neck recurrence had received postoperative radiation therapy and 9 recurred within the field of the SOHND. SOHND is a reliable staging procedure in patients with N 0 oral or oropharyngeal SCC. Therapeutic SOHND, in conjunction with postoperative radiation therapy, was highly effective in controlling neck metastases in carefully selected patients with limited disease in the upper neck.