Hostname: page-component-77f85d65b8-zzw9c Total loading time: 0 Render date: 2026-03-29T16:10:11.809Z Has data issue: false hasContentIssue false
  • English
  • Français

Level I dissection for laryngeal and hypopharyngeal cancer: is it indicated?

Published online by Cambridge University Press:  29 June 2007

Alfio Ferlito  and
Alessandra Rinaldo
Alfio Ferlito*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Udine, Udine, Italy
Alessandra Rinaldo
Affiliation:
Department of Otolaryngology, University of Padua, Padua, Italy
*
Address for correspondence: Professor Alfio Ferlito, M.D., Department of Otolaryngology – Head and Neck Surgery, University of Udine, Policlinico Città di Udine, Viale Venezia 410, 33100 Udine, Italy. Fax: 39-432-532179
Get access Rights & Permissions [Opens in a new window]

Abstract

Squamous cell carcinoma of the larynx and hypopharynx tends to metastasize frequently to cervical lymph nodes, the location of which depends mainly on the site of the primary lesion. Five anatomical levels of cervical nodes have consequently been defined to standardize the terminology used to describe which lymph node groups are at risk for metastatic spread. Level I includes the submental and submandibular triangles. This review considers the role of these triangles in neck dissection and concludes that, unless there is clear evidence of spread, the inclusion of the level I triangles in the neck dissection is unwarranted since these nodes are not really at risk. There is therefore an important role for selective neck dissection in suitable cases of squamous cell carcinoma of the larynx and hypopharynx.

Keywords

Laryngeal neoplasmsHypopharyngeal neoplasmsLymph nodes

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 5 , May 1998 , pp. 438 - 440
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

The present study was supported by The Laryngeal Cancer Association

References

Byers, R. M., Wolf, P. F., Ballantyne, A. J. (1988) Rationale for elective modified neck dissection. Head and Neck Surgery 10: 160–167.CrossRefGoogle ScholarPubMed
Candela, F. C., Shah, J., Jaques, D. P., Shah, J. P. (1990) Patterns of cervical node mestastases from squamous carcinoma of the larynx. Archives of Otolaryngology – Head and Neck Surgery 116: 432–435.CrossRefGoogle Scholar
Feind, C. R. The head and neck. (1972) In The Lymphatics in Cancer. (Haagensen, C. D., Feind, C. R., Herter, F. P., Slanetz, C. A., Weinberg, J. A., eds.) Saunders, Philadelphia, pp 59–230.Google Scholar
Feldman, D. E., Applebaum, E. L. (1977) The submandibular triangle in radical neck dissection. Archives of Otolaryngology 103: 705–706.CrossRefGoogle ScholarPubMed
Li, X. M., Wei, W. I., Guo, X. F., Yuen, P. W., Lam, L. K. (1996) Cervical lymph node metastatic patterns of squamous carcinomas in the upper aerodigestive tract. Journal of Laryngology and Otology 110: 937–941.CrossRefGoogle ScholarPubMed
Lindberg, R. (1972) Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 229: 1446–1449.3.0.CO;2-C>CrossRefGoogle Scholar
Moe, K., Wolf, G. T., Fisher, S. G., Hong, W. K. (1996) Regional metastases in patients with advanced laryngeal cancer. Archives of Otolaryngology – Head and Neck Surgery 122: 644–648.CrossRefGoogle ScholarPubMed
Pellitteri, P. K., Robbins, K. T., Neuman, T. (1997) Expanded application of selective neck dissection with regard to nodal status. Head and Neck 19: 260–265.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Pietrantoni, L., Fior, R. (1958) Clinical and surgical problems of cancer of the larynx and hypopharynx. A review of 570 consecutive cases operated on in the Ear, Nose and Throat Clinic of the University of Milan between 1948 and 1954, with special regard to the problem of metastases. Acta Otolaryngologica (Stockh) (Suppl 142): 1–61.Google Scholar
Redaelli de Zinis, L. O., Nicolai, P., Barezzani, M. G., Tomenzoli, D., Antonelli, A. R. (1994) Incidenza e distribuzione delle metastasi linfonodali nel carcinoma laringeo sopraglottico: implicazioni terapeutiche. Acta Otorhinolaryngologica Italica 14: 19–27.Google Scholar
Robbins, K. T. (1994) Neck dissection: classification and incisions. In The Neck. Diagnosis and Surgery. (Shockley, W. W., Pillsbury, H. C. III, eds.) Mosby, St Louis, pp 381–391.Google Scholar
Robbins, K. T., Medina, J. E., Wolfe, G. T., Levine, P. A., Sessions, R. B., Pruet, C. W. (1991) Standardizing neck dissection terminology. Official report of the Academy's Committee for head and neck surgery and oncology. Archives of Otolaryngology – Head and Neck Surgery 117: 601–605.CrossRefGoogle ScholarPubMed
Rouvière, H. (1932) Anatomie des lymphatiques de l'homme. Masson, Paris, France, p 110.Google Scholar
Shah, J. P., Strong, E. W., Spiro, R. H., Vikram, B. (1981) Neck dissection: current status and future possibilities. Clinical Bulletin 11: 25–33.Google ScholarPubMed
Strasnick, B., Moore, D. M., Abemayor, E., Juillard, G., Fu, Y. S. (1990) Occult primary tumors. The management of isolated submandibular lymph node metastases. Archives of Otolaryngology – Head and Neck Surgery 116: 173–176.CrossRefGoogle ScholarPubMed
Wenig, B. L., Applebaum, E. L. (1991) The submandibular triangle in squamous cell carcinoma of the larynx and hypopharynx. Laryngoscope 101: 516–518.CrossRefGoogle ScholarPubMed