Corlette Toby H, Cole Ian E, Albsoul Nader, Ayyash Mohammad
Department of Otorhinolaryngology Surgery, St Vincent's Hospital, Sydney, Australia.
Laryngoscope. 2005 Sep;115(9):1624-6. doi: 10.1097/01.mlg.0000173154.92581.c5.
To determine whether resection of level IIb is necessary in elective or therapeutic neck dissections.
Prospective case series.
Level IIb nodes were analyzed for micrometastases as separate specimens in 160 neck dissections on 148 patients with squamous cell carcinoma of the head and neck.
In 106 elective neck dissections (N0 necks) from upper aerodigestive tract (UADT) and skin/parotid squamous carcinoma primaries, level IIb was involved in 4.5% and 33%, respectively. In 54 therapeutic neck dissections (N+ necks) from UADT and skin/parotid squamous carcinoma primaries, level IIb was involved in 25% and 71%, respectively. Apart from skin/parotid squamous carcinoma primaries, level IIb was never involved unless level IIa was also involved.
Level IIb nodes can be left in situ in UADT primary carcinomas in nontonsillar N0 necks without significantly compromising regional clearance of micrometastases.
确定在选择性或治疗性颈部清扫术中是否有必要切除Ⅱb区。
前瞻性病例系列研究。
在148例头颈部鳞状细胞癌患者的160例颈部清扫术中，将Ⅱb区淋巴结作为单独标本分析微转移情况。
在上呼吸道消化道（UADT）和皮肤/腮腺鳞状癌原发灶的106例选择性颈部清扫术（N0颈部）中，Ⅱb区受累率分别为4.5%和33%。在UADT和皮肤/腮腺鳞状癌原发灶的54例治疗性颈部清扫术（N+颈部）中，Ⅱb区受累率分别为25%和71%。除皮肤/腮腺鳞状癌原发灶外，除非Ⅱa区也受累，Ⅱb区从不受累。
在非扁桃体N0颈部的UADT原发性癌中，Ⅱb区淋巴结可原位保留，而不会显著影响微转移灶的区域清除。
