Pearls and Pitfalls
The presence of a clinically palpable, unilateral, firm, enlarged cervical lymph node in an adult should be considered metastasis until proven otherwise, and should initiate a systemic search for the primary site.
Despite the advent of new diagnostic studies, a detailed patient history, physical examination, and fine-needle aspiration biopsy are the cornerstones of the evaluation of enlarged cervical nodes.
Metastases to the cervical lymphatics at presentation constitute the single most important factor determining outcome of patients with head and neck squamous cell carcinoma.
Regional lymphatic metastases from head and neck neoplasms occur in a predictable and sequential fashion to specific regional lymph nodal groups.
If the risk of occult metastasis is greater than 10–20%, elective dissection of the neck nodes is recommended.
Selective neck dissection is used for accurate staging and treatment of the clinically negative neck at risk for harboring micrometastases.
Keywords
Neck Dissection Internal Jugular Vein Hyoid Bone Sternocleidomastoid Muscle Radical Neck DissectionSelected Readings
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