Background: The purpose of this study was to determine the prevalence of level IIb metastasis in patients with Head and Neck squamous cell carcinomas (HNSCCs).

Material and Methods: A prospective analysis of 44 patients with HNSCC who underwent surgical treatment of the primary lesion with simultaneous neck dissection was performed. During neck dissection, level IIb lymphnodes were separately removed and processed. Neck dissection was bilateral in 3 patients and unilateral in 41 patients

Results: The mean number of nodes found in the level IIb specimens was 4.7 (range: 0–8nodes). The prevalence of metastasis at level IIb was 0% in pN0 necks and 13% in pN+ necks, with an overall prevalence of 6.8%. A significant association between metastasis to level IIb and type of neck dissection was observed. There were no isolated metastases to level IIb without the involvement of other nodes in the remaining neck specimen.

Conclusions: Based on our findings, we suggest that dissection of the level IIb region in patients with HNSCC may be required only in patients with multilevel neck metastasis or if level IIa metastasis is found intra operatively.