Supraomohyoid neck dissection: rationale, indications, and surgical technique

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Oral Cancer Management

Background:

• The supraomohyoid neck dissection is a selective cervical node dissection.
• It involves removing lymph node level I (submental and submandibular triangles) and lymph node levels II and III.
• Key structures like the sternocleidomastoid muscle, spinal accessory nerve, and internal jugular vein are preserved.

Purpose of the Study:

• To discuss the rationale, staging, and therapeutic value of supraomohyoid neck dissection.
• To present a detailed description of the surgical technique for this procedure.
• To highlight its application in managing advanced oral cavity squamous cell carcinomas.

Main Methods:

• Selective cervical node dissection focusing on lymph node levels I, II, and III.
• Preservation of the sternocleidomastoid muscle, spinal accessory nerve, and internal jugular vein.
• Surgical technique detailed for application in specific oral cancer cases.

Main Results:

• The procedure is indicated for large T2, T3, and T4 oral cavity squamous cell carcinomas.
• It is suitable for patients with clinically negative (N0) or limited N1 cervical lymph node involvement.
• Preservation of major neurovascular structures is a key feature.

Conclusions:

• Supraomohyoid neck dissection is a valuable selective approach for managing advanced oral cavity cancers.
• The technique allows for targeted lymph node removal while minimizing morbidity by preserving critical anatomical structures.
• Its application in N0 and N1 disease contributes to effective cancer staging and treatment.