title: Cadaver study on the location of suboccipital lymph nodes: Guidance for suboccipital node dissection.
abstract: BACKGROUND
  The purpose of this study was to provide anatomic guidance for the extent (technique) of suboccipital node dissection.
  
  
  METHODS
  Five human cadaver necks (9 sides) were studied. Boundaries were the superior nuchal line and external occipital protuberance (cranial), the nuchal ligament (medial), an imaginary line through C7 (caudal), and the posterior wall of the auditory channel (anterior). The overlying skin and complete thickness of the cranial part of the trapezius muscle and fascia sheath was included (deep).
  
  
  RESULTS
  An average number of 4 lymph nodes per suboccipital side were found. Diameters ranged from 1 to 6 mm. Twenty nodes (63%) were located in the subcutaneous tissue, 12 (37%) were found just underneath the superficial fascia of the trapezius muscle.
  
  
  CONCLUSIONS
  Suboccipital nodes are small and mainly located in the subcutaneous layer, with a minority just underneath the superficial fascia of the trapezius muscle. This anatomic knowledge was used to refine the suboccipital dissection.
authors.affiliation: Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Hidde J
authors.initials: HJ
authors.lastname: Veenstra
authors.forename: W Martin C
authors.initials: WM
authors.lastname: Klop
authors.forename: Peter J F M
authors.initials: PJ
authors.lastname: Lohuis
authors.forename: Omgo E
authors.initials: OE
authors.lastname: Nieweg
authors.forename: M Loes
authors.initials: ML
authors.lastname: van Velthuysen
authors.forename: Alfons J M
authors.initials: AJ
authors.lastname: Balm
mesh_terms: D002102:Cadaver; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000033:anatomy & histology* / Q000601:surgery*; D008297:Male; D009333:Neck; D009334:Neck Muscles / Q000033:anatomy & histology / Q000601:surgery
keywords: cadaver; dissection; lymph nodes; suboccipital; technique