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Related Experiment Videos

Supraspinal accessory lymph node metastases in supraomohyoid neck dissection

D H Kraus1, D B Rosenberg, B J Davidson

  • 1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

American Journal of Surgery
|December 1, 1996
PubMed
Summary

Supraomohyoid neck dissection for oral cancer staging rarely involves the supraspinal accessory lymph nodes. This study found a low incidence of metastases to this specific lymph node pad in patients with squamous cell carcinoma.

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Area of Science:

  • Surgical Oncology
  • Head and Neck Cancer
  • Pathology

Background:

  • Supraomohyoid neck dissection is used for staging oral and oropharyngeal squamous cell carcinoma.
  • Dissection of supraspinal accessory lymph nodes requires spinal accessory nerve traction.
  • The necessity of dissecting these nodes is unclear due to lack of data on metastasis incidence.

Purpose of the Study:

  • To determine the incidence of metastases to the supraspinal accessory lymph node pad.
  • To evaluate the necessity of dissecting these nodes during supraomohyoid neck dissection for oral cancer.

Main Methods:

  • Prospective analysis of 44 patients with newly diagnosed oral or oropharyngeal squamous cell carcinoma.
  • Patients underwent unilateral or bilateral supraomohyoid neck dissection.

Related Experiment Videos

  • Supraspinal accessory lymph node pads were submitted separately for pathological evaluation.

    • Main Results:

    • 15 patients (32%) had microscopic metastases in the supraomohyoid neck dissection specimen.
    • Only 1 patient (2.3%) had a metastatic deposit in the supraspinal accessory lymph node pad.
    • This patient also had metastases in level II lymph nodes; metastasis incidence was equal across T stages.

    Conclusions:

    • The incidence of supraspinal accessory lymph node metastases in T+N0 oral and oropharyngeal squamous cell carcinoma is low.
    • Further patient accrual is needed to confirm if metastasis incidence varies with patient numbers.