Need for Dissection of level IIb in squamous cell carcinoma of oropharynx: A review of literature

Dr Ashwini Munnangi; Dr Aafreen Aftab; Dr Shruti khatana

Volume : VII, Issue : IV, April - 2018

Need for Dissection of level IIb in squamous cell carcinoma of oropharynx: A review of literature

Dr Ashwini Munnangi, Dr Aafreen Aftab, Dr Shruti Khatana

Abstract :

Neck dissection in Squamous Cell Carcinoma (SCC) of oro–pharynx usually involves removal of lymph node groups in level I to V, when the neck nodes are clinically positive. The dissection of level IIb may cause damage to the Spinal Accesory Nerve (SAN) leading to postoperative morbidity. In the setting of a clinically negative neck (N0) with probable occult metastases, the need for dissection of level IIb is debatable. This review evaluates the prevalence of occult metastases to level IIb in SCC of oro–pharynx. A systematic literature search was adopted to identify articles relevant to the present review, which revealed a higher tendency for involvement of level IIb when the primaries were the tonsil and base of tongue. Through this review, it is possible to conclude that in cases of primary sites involving the tonsil and base of tongue in a clinically negative neck, level IIb inclusion in the neck dissection specimen is recommended.