9 Supraomohyoid Neck Dissection

Oral tumours are a common malignancy, with smoking and alcohol the principal aetiological factors. Squamous cell carcinoma is the commonest pathology, most frequently affecting the anterior tongue and floor of the mouth. Surgery is the mainstay of T1/T2 tumour management, and tracheostomy may be required. Sentinel node biopsy is an effective staging procedure; however, there is a high rate of occult nodal metastasis which may warrant elective supraomohyoid neck dissection. Macroscopic nodal disease requires modified radical neck dissection, preferably with adjuvant chemoradiotherapy. For unresectable tumours, radical external beam radiotherapy with cisplatin should be given. Reconstruction of soft tissue involves a range of skin grafts and local, regional, and free flaps, while bony reconstruction includes obturators and non-vascularized and vascularized bone grafts. Postoperative rehabilitation aims to restore speech, mastication, swallow, and dentition. Three-year survival is greater than 90% for stage I/II disease, with excellent functional outcomes.

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The role of supraomohyoid neck dissection in patients of oral cavity carcinoma☆☆This paper will be read before the “7th International Congress on Oral Oncology”. The Haque, The Netherlend, 22–26 April 2001.

Oral Oncology ◽

10.1016/s1368-8375(01)00061-6 ◽

2002 ◽

Vol 38 (3) ◽

pp. 309-312 ◽

Cited By ~ 19

Author(s):

Sheng-Po Hao ◽

Ngan-Ming Tsang

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

International Congress ◽

Oral Cavity Carcinoma ◽

Supraomohyoid Neck Dissection ◽

Oral Oncology

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Late nodal metastasis of T2 oral cancer can be reduced by a combination of preoperative ultrasonographic examination and frozen section biopsy during supraomohyoid neck dissection

Acta Oto-Laryngologica ◽

10.3109/00016489.2011.598553 ◽

2011 ◽

Vol 131 (11) ◽

pp. 1214-1219 ◽

Cited By ~ 1

Author(s):

Koutetsu Lee ◽

Shuji Nishikawa ◽

Katsuhiro Yoshimura ◽

Ryo Kawata

Keyword(s):

Oral Cancer ◽

Neck Dissection ◽

Frozen Section ◽

Nodal Metastasis ◽

Ultrasonographic Examination ◽

Supraomohyoid Neck Dissection

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Minimally invasive supraomohyoid neck dissection by total endoscopic technique for oral squamous carcinoma

Surgical Endoscopy ◽

10.1007/s00464-015-4427-z ◽

2015 ◽

Vol 30 (6) ◽

pp. 2315-2320 ◽

Cited By ~ 4

Author(s):

Ravindrasinh Raj ◽

Vikram Lotwala ◽

Piyush Anajwala

Keyword(s):

Minimally Invasive ◽

Neck Dissection ◽

Squamous Carcinoma ◽

Endoscopic Technique ◽

Oral Squamous Carcinoma ◽

Supraomohyoid Neck Dissection

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Precise Intraoperative Lymph Node Identification by Isosulfan Blue of Occult Neck Lymph Node Metastases for Decision to Convert from Supraomohyoid Neck Dissection to Comprehensive Neck Dissection in Early-Stage Oral Cancer

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2021/v19i630338 ◽

2021 ◽

pp. 54-60

Author(s):

Somjin Chindavijak

Keyword(s):

Lymph Node ◽

Oral Cancer ◽

Lymph Nodes ◽

Neck Dissection ◽

Early Stage ◽

Isosulfan Blue ◽

Neck Lymph Node ◽

Blue Node ◽

Metastatic Lymph ◽

Supraomohyoid Neck Dissection

Objective: To study the sensitivity and specificity of peritumoral isosulfan blue dye injection for localization of suspected metastatic lymph nodes. Materials and methods: The study included all patients diagnosed with early-stage oral cancer between January 2018 and March 2020. After elevation of the skin flap, the primary site was injected peritumorally with isosulfan blue 0.3-0.5 cc at 1 cm intervals and massaged. The time at which any draining nodes turned blue was recorded and the node was then excised for frozen section. After which supraomohyoid neck dissection was performed. The frozen sections were stained with H&E and analyzed for presence of metastases. Negative sections were further analyzed using immunohistochemistry stains. Sensitivity, specificity and time of identification suspected metastatic lymph node were analyzed . Results: Nineteen patients with early-stage oral cancer were included. The majority (78.4%) presented with tongue lesions. The mean injection amount administered was 3.62±0.83 cc, and the number of injections around the tumor were 10.26±2.31. Mean duration from time of injection to the identification of a blue node was 19.26±15.99 min. Nodes at Level I of the neck were the most common identified as blue nodes (57.8%). Statistical analysis comparing pathological findings with blue node identification revealed this technique has a sensitivity of 71.4% with specificity of 91.7% and an overall accuracy of 84.2% in identify metastasis lymph node. Conclusion: Isosulfan blue injection of primary oral tumors demonstrated a high level of efficiency in identifying metastatic lesions in draining lymph nodes. This technique may be helpful in deciding intraoperatively whether to convert from supraomohyoid neck dissection to comprehensive neck dissection .

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