title: Neck dissection of level IIb: is it really necessary?
abstract: OBJECTIVE
  To determine whether resection of level IIb is necessary in elective or therapeutic neck dissections.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Level IIb nodes can be left in situ in UADT primary carcinomas in nontonsillar N0 necks without significantly compromising regional clearance of micrometastases.
authors.affiliation: Department of Otorhinolaryngology Surgery, St Vincent's Hospital, Sydney, Australia. t.corlette@garvan.org.au
authors.forename: Toby H
authors.initials: TH
authors.lastname: Corlette
authors.forename: Ian E
authors.initials: IE
authors.lastname: Cole
authors.forename: Nader
authors.initials: N
authors.lastname: Albsoul
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ayyash
mesh_terms: D061227:Accessory Nerve Injuries; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods*; D010307:Parotid Neoplasms / Q000601:surgery; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000601:surgery