Baredes S, Nussbaum M, Som M L
Laryngoscope. 1985 Feb;95(2):151-5. doi: 10.1288/00005537-198502000-00005.
Uncontrolled cervical metastasis is the most common source of failure in the surgical treatment of supraglottic carcinoma. This study was designed to determine the value of supraomohyoid neck dissection in patients undergoing supraglottic laryngectomy. The rationale for considering the role of supraomohyoid neck dissection is that such a dissection encompasses the subdigastric and midjugular nodes which are the first echelon of lymphatic drainage of the supraglottic larynx. Thirty-eight patients with a diagnosis of epidermoid carcinoma of the supraglottis were treated by subtotal supraglottic laryngectomy (SSL). Ten patients underwent SSL with no neck dissection, 16 patients underwent SSL with supraomohyoid neck dissection (SOHD)--9 unilateral and 7 bilateral, and 12 patients underwent SSL with radical neck dissection (RND). The 3 groups had comparable T classifications. All of the SSL and SSL with SOHD patients were classified as N0. Of the 12 patients treated with SSL and RND, 4 were classified as N0, 4 as N1, 3 as N2, and 1 as N3. The patients were studied to determine the incidence and pattern of subsequent neck disease, survival, complications, and length of hospitalization. The data indicates that supraomohyoid neck dissection offers little benefit as an adjunct to supraglottic laryngectomy.
未控制的颈部转移是声门上型癌手术治疗失败的最常见原因。本研究旨在确定肩胛舌骨肌上颈清扫术在接受声门上喉切除术患者中的价值。考虑肩胛舌骨肌上颈清扫术作用的理论依据是，这种清扫术涵盖了二腹肌下和颈中淋巴结，它们是声门上喉淋巴引流的第一站。38例诊断为声门上型表皮样癌的患者接受了声门上喉次全切除术（SSL）。10例患者接受了未行颈清扫术的SSL，16例患者接受了肩胛舌骨肌上颈清扫术（SOHD）的SSL——9例单侧和7例双侧，12例患者接受了根治性颈清扫术（RND）的SSL。3组患者的T分级具有可比性。所有接受SSL和接受SOHD的SSL患者均分类为N0。在12例接受SSL和RND治疗的患者中，4例分类为N0，4例为N1，3例为N2，1例为N3。对患者进行研究以确定后续颈部疾病的发生率和模式、生存率、并发症及住院时间。数据表明，肩胛舌骨肌上颈清扫术作为声门上喉切除术的辅助手段益处不大。
