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Young Chang Lim, MD; Mee Hyun Song, MD; Sang Cheol Kim, MD; Kwang Moon Kim, MD; Eun Chang Choi, MD, PhD

Arch Otolaryngol Head Neck Surg. 2004;130:1088-1091.

Objective  To determine whether level IIb lymph nodes can be saved in elective supraomohyoid neck dissection (SOHND) as a treatment for patients with squamous cell carcinoma of the oral cavity.

Design  Prospective analysis of a case series.

Setting  University hospital.

Patients and Interventions  From 1997 to 2001, 74 patients with squamous cell carcinoma of the oral cavity and with no palpable lymph nodes at the neck who underwent an elective SOHND were prospectively studied.

Main Outcome Measures  The incidence of pathological metastasis to level IIb lymph nodes and the regional recurrence within this area after elective SOHND was performed were evaluated.

Results  Of the 74 patients, 24 (32%) had lymph nodes positive for microscopic metastatic squamous cell carcinoma. Four (5%) of the 74 patients had involvement of level IIb lymph nodes. There was no instance of isolated metastasis to level IIb lymph nodes without involvement of other nodes in the SOHND specimens. There were 6 cases of the ipsilateral neck recurrences, and of these, 2 patients (3% of all patients) developed recurrences in the level II lymph nodes.

Conclusions  Level IIb lymph node metastasis was rare in this study, and nodal recurrence in this area after SOHND in squamous cell carcinoma of the oral cavity was infrequent. Therefore, this region may be preserved in elective SOHND in patients with squamous cell carcinoma of the oral cavity.

From the Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea. Dr Lim is now with the Department of Otorhinolaryngology–Head and Neck Surgery, Konkuk University College of Medicine, Seoul. The authors have no relevant financial interest in this article.

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