Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich Medical Center, Munich, Germany.
Head Neck. 2011 Feb;33(2):239-43. doi: 10.1002/hed.21436.
The decision whether to perform an elective neck dissection in patients with head and neck squamous cell carcinoma (HNSCC) and clinically negative lymph nodes (cN0) is made based on the probability of micrometastases in the neck for the given subsite and size of the primary. To date there is limited information about contralateral and bilateral cervical lymph node metastases of oropharyngeal carcinoma.
A retrospective chart review was performed of 352 patients with oropharyngeal SCC who received a bilateral neck dissection. The frequency of histologically unveiled bilateral neck metastases was determined.
Carcinomas of the tonsillar fossa starting with a T2 classification and carcinomas of the soft palate, base of tongue, and pharyngeal wall at any stage showed a high frequency of bilateral metastases.
Bilateral neck dissection should be recommended for all but T1 and selected cases of T2 carcinomas of the tonsillar fossa.
对于头颈部鳞状细胞癌（HNSCC）且临床检查无颈部淋巴结转移（cN0）的患者，是否行择期颈清扫术的决策取决于特定部位和原发灶大小的颈部微转移概率。迄今为止，关于口咽癌对侧和双侧颈淋巴结转移的信息有限。
对 352 例接受双侧颈清扫术的口咽鳞癌患者进行回顾性图表审查。确定了组织学证实的双侧颈部转移的频率。
T2 分级的扁桃体窝癌和任何分期的软腭、舌根和咽壁癌，其双侧转移的发生率较高。
除 T1 和选择性 T2 扁桃体窝癌外，应推荐对所有患者行双侧颈清扫术。
