Selective Neck Dissection (IIa, III): A Rational Replacement for Extended Supraomohyoid Neck Dissection in Patients with N0 Supraglottic and Glottic Squamous Cell Carcinoma.
OBJECTIVE
To evaluate the effectiveness of selective neck dissection of sublevel IIa and level III in cases of glottis and supraglottic laryngeal carcinoma in the absence of lymph node metastasis and to show if there is value in dissecting the sublevel IIb or level IV in these cases.


METHODS
Twenty-five patients with N0 glottic or supraglottic cancer were subjected to unilateral or bilateral selective neck dissection according to the site and the extent of the tumor, and the specimens were histopathologically examined for metastasis.


RESULTS
Twenty-five patients (23 males and 2 females) with mean age of 55.72 years were included in the study. Lymph node metastasis to sublevel IIa and level III was found in 6/25 (24%) cases with glottic or supraglottic carcinoma, while to sublevel IIb and level IV was found in 1/25 (4%) with P-value of 0.05, which is statistically significant.


CONCLUSIONS
Selective neck dissection of level IIb is not required in cases of the supraglottic laryngeal cancer. Dissection of sublevel IIa and level III takes less time and is effective. Dissection of level IV is not needed in the case of supraglottic cancer.
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.
Ismail
I
Zohdi
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.
Louay S
LS
El Sharkawy
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.
Mahmoud F
MF
El Bestar
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.
Hazem M
HM
Abdel Tawab
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.
Mo'men Aa
MA
Hamela
Department of Pathology, Faculty of Medicine, Cairo University, Egypt.
Amal A
AA
Hareedy
lymph node; neck dissection; supraglottic