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The submandibular triangle in radical neck dissection.

D E Feldman, E L Applebaum

    Archives of Otolaryngology (Chicago, Ill. : 1960)
    |December 1, 1977
    PubMed
    Summary
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    Radical neck dissection for laryngeal cancer may not require removing submandibular triangle contents. This modification could minimize cosmetic and functional issues while maintaining oncologic safety in select cases.

    Area of Science:

    • Head and Neck Surgery
    • Surgical Oncology
    • Anatomic Pathology

    Background:

    • Radical neck dissection (RND) is a standard surgical procedure for head and neck cancers.
    • Modifications to RND aim to improve outcomes and reduce morbidity.
    • The necessity of removing submandibular triangle contents in RND is debated.

    Purpose of the Study:

    • To evaluate the involvement of the submandibular triangle by metastatic squamous cell carcinomas.
    • To determine if submandibular triangle dissection is essential in all RND procedures for head and neck cancers.

    Main Methods:

    • Retrospective analysis of 51 neck dissection specimens.
    • Histopathological examination of lymph nodes within the submandibular triangle.
    • Correlation of metastatic involvement with primary tumor site.

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    Main Results:

    • Only 3 out of 51 specimens (5.9%) showed metastases to submandibular triangle lymph nodes.
    • Metastases were observed in cancers originating from the nose, floor of mouth, and retromolar trigone.
    • No laryngeal tumors (0 out of 26) in this series had spread to the submandibular triangle.

    Conclusions:

    • Submandibular triangle dissection may be omitted in RND for laryngeal cancer when lymph nodes are not palpable.
    • Selective omission of submandibular triangle contents could reduce functional and cosmetic deficits.
    • Further research may refine indications for submandibular triangle dissection in head and neck cancer surgery.