title: The necessity of dissection of level IIb in laryngeal squamous cell carcinoma: a clinical study.
abstract: OBJECTIVE
  Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This is seen frequently in laryngeal squamous cell carcinoma (LSCC), and neck dissection may be performed in addition to excision of the primary lesion. The aim of this study was to define the frequency of level IIb metastasis to the lymph nodes in patients who underwent selective neck dissection because of LSCC.
  
  
  METHODS
  Cross-sectional study with planned data collection in a tertiary referral hospital.
  
  
  METHODS
  Eighty-one patients diagnosed with LSCC were accepted into the study. One hundred forty-eight neck dissection specimens were examined histopathologically, and those with level IIb metastasis were identified. The frequency of level IIb metastasis was evaluated in accordance with the primary tumor site, clinical N stage, central tumor presence, and T stage.
  
  
  RESULTS
  Forty-seven of 81 patients were clinically N-, and 34 patients were clinically N+. Level IIb metastasis was seen in 5 (6%) of 81 patients, representing 5 of 148 neck dissection specimens. Two of these 5 patients were clinically N+ (6%), and 3 were clinically N- (6%). The relationship between level IIb metastasis and clinical N stage was not statistically significant (P ≥ .05). Likewise, no statistically significant relationships between the other parameters and level IIb involvement were found.
  
  
  CONCLUSIONS
  Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Kızıltepe State Hospital, Ministry of Health, Mardin, Turkey.
authors.forename: Riza
authors.initials: R
authors.lastname: Dündar
authors.forename: Hale
authors.initials: H
authors.lastname: Aslan
authors.forename: Can
authors.initials: C
authors.lastname: Özbay
authors.forename: Sinan
authors.initials: S
authors.lastname: Basoglu
authors.forename: Isil Adadan
authors.initials: IA
authors.lastname: Güvenç
authors.forename: Evren Ay
authors.initials: EA
authors.lastname: Ögredik
authors.forename: Sedat
authors.initials: S
authors.lastname: Öztürkcan
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Tayfun
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Katilmis
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods / Q000401:mortality; D008197:Lymph Node Excision / Q000379:methods / Q000401:mortality; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D011446:Prospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome