[Application of chlorophyll in the cervical lymph nodes dissection of laryngeal and hypopharyngeal carcinomas].
OBJECTIVE
To investigate the patterns of cervical lymph node metastases from the carcinomas of larynx and hypopharynx.


METHODS
Chlorophyll solution was injected submucosally into some portions of the larynx and hypopharynx preoperately as a stain of lymphatic system to help conduct modified neck dissections in 50 patiants with laryngeal or hypopharyngeal carcinomas. Searial sections were performed.


RESULTS
The cervical lymph nodes were stained into deep green with a color contrast to the ambient structures, which facilitated the operation of neck dissections and the distinction of lymph nodes. Pathologically positive lymph nodes found in 48% of all the cases. The metastases to level I and V were always associated with other levels. By statistical analysis, there was a higher metastaic rate in level II, III, and V (P < 0.01). Overal 1 occult metastases were recorded in 23.5% of No (clinically negative neck)cases. The involvement were located only at level II or III.


CONCLUSIONS
For cN+ (clinically positive neck) patiants, upper and middle jugular vein nodes should be dissected necessarilly,and then appropriate selective neck dissections might be considerd according to the intraoperative findings. For the cN(o) cases with supraglottic or hypopharyngeal carcinomas, it is suggested ipsilateral or bilateral upper and middle jugular vein nodes be dissected according to the clinical status. Chlorophyll as a kind of safe and distinctive stain of lymphatic system can be injected preoperatively routinely.
Qiu
Yizhou
Y
Department of Otorhinolaryngology, Weifang People's Hospital, Weifang 261041.
Liu
Qingming
Q
Zhang
Shinuan
S
Han
Zaiwen
Z
Ding
Hao
H
Guo
Aihua
A
D000328:Adult; D000368:Aged; D002734:Chlorophyll / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection / Q000379:methods*
D002734:Chlorophyll