Assessment and management of metastatic neck disease

2021 ◽  
pp. 897-902
Author(s):  
Vinidh Paleri ◽  
Maniram Ragbir
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Primary Tumour ◽  
Neck Surgery ◽  
Primary Site ◽  
Upper Aerodigestive Tract ◽  
Neck Node ◽  
Tumour Spread ◽  
Neck Disease ◽  
Choice Of Treatment

Tumour spread to the neck can occur from any primary sites that can harbour squamous cell carcinoma (SCC) in the upper aerodigestive tract (UADT) mucosa. This can also happen with other histological subtypes and from primary sites in the parotid and thyroid gland. Thus, the assessment of the neck should form an integral part of the clinical examination, imaging, and decision-making process prior to deciding treatment of the primary tumour. Given the propensity of these tumours to spread to the lymph nodes and given that the treatment algorithms used to manage lymph nodes in the neck are similar to those options available for the primary site, neck status often influences the choice of treatment. This chapter outlines the assessment and management of the metastatic neck node from an SCC of the UADT. To ensure uniformity in describing and communicating information about neck disease, the neck is divided into six levels, as recommended by the American Head and Neck Society and the American Academy of Otolaryngology–Head and Neck Surgery.

Internal jugular vein blowout complicating head and neck surgery

1994 ◽  
Vol 108 (5) ◽  
pp. 423-425 ◽  
Author(s):  
Conrad V. I. Timon ◽  
Dale Brown ◽  
Patrick Gullane
Keyword(s):  
Head And Neck ◽  
Jugular Vein ◽  
Toronto General Hospital ◽  
Primary Tumour ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Cutaneous Fistula ◽  
Life Threatening ◽  
Functional Neck Dissection ◽  
Carotid Arterial

AbstractInternal jugular venous rupture after head and neck surgery is a rare but important condition to recognize. The Toronto General Hospital experience of this condition, together with its identification and management is reported.Jugular vein rupture should be considered in patients undergoing primary tumour excision with modified or functional neck dissection complicated by a pharyngo-cutaneous fistula. Typically, bleeding is venous and occurs repeatedly. However, haemorrhage may be substantial and life-threatening. Treatment requires exploration and ligation of the venous system. The carotid artery should be assessed and protected at surgery, since there is a likelihood of a carotid blowout as the conditions have a common aetiology. It is important to distinguish jugular vein haemorrhage from carotid arterial rupture, since the former has a far better outcome if treated properly.

Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site

Head & Neck ◽  
1998 ◽  
Vol 20 (8) ◽  
pp. 739-744 ◽  
Author(s):  
William M. Mendenhall ◽  
Anthony A. Mancuso ◽  
James T. Parsons ◽  
Scott P. Stringer ◽  
Nicholas J. Cassisi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Primary Site ◽  
Diagnostic Evaluation ◽  
Cervical Lymph Nodes

Metastases to lymph nodes of the head and neck from an unknown primary site

1977 ◽  
Vol 134 (4) ◽  
pp. 517-522 ◽  
Author(s):  
Donald D. Coker ◽  
Peter F. Casterline ◽  
Robert G. Chambers ◽  
Darrell A. Jaques
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site

scholarly journals Guidelines for safe and optimum neck dissection: a review article

2021 ◽  
Author(s):  
Sheetal A. Murchite ◽  
Thakut Gowtham ◽  
Abhinandan Milind Kadiyal ◽  
Vaishali Vinayak Gaikwad ◽  
Ashutosh Tiwari
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Dissection ◽  
Early Stage ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Regional Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Early Stage Disease ◽  
Regional Metastases

Head and neck cancer is the sixth most common cancer worldwide. The single most important factor affecting prognosis for squamous cell carcinoma is the status of the cervical lymph nodes. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. The American cancer society reports that 40% of patients with squamous carcinoma of the oral cavity and pharynx present with regional metastases to the cervical lymph nodes. This activity presents the steps for safe and optimum neck dissection. Objectives of the study were to identify the anatomical structures in neck dissection, review the complications of head and neck surgery and summarize the importance of care coordination and to improve outcomes for patients undergoing head and neck surgery.

scholarly journals An approach towards metastatic neck nodes and most common site of primaries: a retrospective study

2019 ◽  
Vol 5 (5) ◽  
pp. 1222
Author(s):  
Rudra Prakash ◽  
Smrity Rupa Borah Dutta
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Cancer ◽  
Selective Neck Dissection ◽  
Neck Node ◽  
Cervical Lymph Nodes ◽  
N0 Neck ◽  
Level Ii ◽  
Total Cancer

<p class="abstract"><strong>Background:</strong> Head and neck cancer is one of the most common cancers in India and worldwide. It accounts for 30 percent of the total cancer burden. Head and neck cancers are notorious for loco regional spread presenting late with metastastasis to cervical lymph nodes.</p><p class="abstract"><strong>Methods:</strong> Our study was carried out on patients presenting with metastatic neck nodes at Silchar Medical College and Hospital, Assam from 1<sup>st</sup> April 2013 to 30<sup>th</sup> March 2015.  </p><p class="abstract"><strong>Results:</strong> In our study 167 patients presented with head and neck cancer with metastatic neck nodes. Metastatic nodes involving level II accounted for 51.4% of cases with primaries in oral cavity, base of tongue. Level III lymph nodes were involved in 48.6% of cases with primaries in the hypopharynx and larynx.</p><p><strong>Conclusions:</strong> In our study it was found that hypopharynx is the most common primary head and neck cancer with metastatic neck node. The most commonly involved lymph nodes are level II and level III. This helps in understanding the pattern of micrometastases in head and neck cancer patients with N0 neck which makes way for the role of selective neck dissection in these groups of patients.</p>

scholarly journals Neck dissection for head and neck malignancies: A Malaysian 13 years review

2017 ◽  
Vol 16 (3) ◽  
pp. 384-396
Author(s):  
Nik Hisyam Amirul Nik Hishamuddin ◽  
Mawaddah Azman ◽  
Min Han Kong ◽  
Marina Mat Baki ◽  
Primuharsa Putra Sabir Husin Athar ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Strong Association ◽  
Medical Science ◽  
Wound Complications ◽  
Neck Node ◽  
Tertiary Centre ◽  
Marginal Mandibular Nerve ◽  
Neck Disease ◽  
Lymphatic Complications

Introduction and Objective: Neck dissection (ND) is a surgical procedure performed in treating head and neck cancer patients with cervical neck metastasis. The aim of neck dissection is to achieveloco-regional control thus optimizing the cancer’s cure rate. Various complications may potentially occur following this surgery. The main objective of this study is to evaluate the incidence of complications following neck dissection.Materials & Methods: This is a 13 years retrospective descriptive case notes analysis conducted in UKMMC (University Kebangsaan Malaysia Medical Centre), a tertiary centre in Malaysia. Neck dissection surgeries that were performed between January 2000tillDecember 2012 were recruited for data analyses.Results: A total of 233 neck dissections were performed in our centre over 13 years period from January 2000 until December 2012. Of these, 27 cases were excluded due to unavailability of data and therefore a total of 206 cases were recruited for data analyses.The types of neck dissection performed include Extended Radical ND (n=7), Radical ND (n=40), Modified Radical ND (n=88) and Selective ND (n=71). Majority of neck dissection was performed for malignant oral cavity tumours (47.1%). Out of 206 cases, 57 (27.7%) developed wound complications, 48 (23.3%) cases had nerve complications with marginal mandibular nerve was most commonly injured (13%) and 20 (9.7%) cases had vascular and lymphatic complications mainly involving the thoracic duct (5.3%). The incidence of residual or recurrent neck disease was observed in 41 cases (20%). Pre-operative clinical assesment of cervical neck node metastatic status has a high sensivity of 89.7% but low specificity of 47.5%.Conclusion: Various complications may potentially occur following neck dissection. Awareness of these possible complications could minimize the incidence of complication following this surgery. This current study observed a strong association between the type of neck dissection performed with the incidence of wound, nerve and vascularcomplications following neck dissection surgery.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.384-396

Irradiation-Induced Atherosclerosis: A Factor in Therapeutic Planning

1992 ◽  
Vol 101 (3) ◽  
pp. 222-228 ◽  
Author(s):  
W. Frederick McGuirt ◽  
Robert S. Feehs ◽  
Harriet L. Strickland ◽  
Gene Bond ◽  
William M. McKinney
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Carotid Atherosclerosis ◽  
Case Reports ◽  
Neck Disease ◽  
Choice Of Treatment ◽  
Long Term Follow Up ◽  
Early Primary

Early primary head and neck cancers (stages I and II) and occult metastatic neck disease have caused debate regarding the choice between surgery and irradiation. The arguments for each are reviewed with a new consideration: the acceleration and/or induction of carotid atherosclerosis in irradiated patients. We present clinical case reports (n = 9), a retrospective clinical evaluation for the occurrence of carotid atherosclerosis in irradiated head and neck cancer patients (n = 57), and a comparison study of the extent and distribution of atherosclerosis in irradiated (n = 29) and nonirradiated head and neck cancer patients controlled for age, blood pressure, and tobacco use. The results show that carotid atherosclerosis is found in a wider anatomic distribution and to a greater extent in irradiated than in nonirradiated patients. We conclude that carotid atherosclerosis is induced and/or accelerated by neck irradiation. The implications as they relate to choice of treatment, to pretreatment evaluations, and to long-term follow-up are discussed.

scholarly journals A Review of Radiotherapy for Merkel Cell Carcinoma of the Head and Neck

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Justin Lee ◽  
Ian Poon ◽  
Judith Balogh ◽  
May Tsao ◽  
Elizabeth Barnes
Keyword(s):  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Merkel Cell Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Primary Tumour ◽  
Critical Role ◽  
Lymph Node Biopsy ◽  
Merkel Cell ◽  
Regional Lymph Nodes

Merkel cell carcinoma of the head and neck (MCCHN) presents a clinical challenge due to its aggressive natural history, unpredictable lymphatic drainage, and high degree of treatment related morbidity. Histological examination of the regional lymph nodes is very important in determining the optimal treatment and is usually achieved by sentinel lymph node biopsy. Radiotherapy plays a critical role in the treatment of most patients with MCCHN. Surgery with adjuvant radiotherapy to the primary tumour site is associated with high local control rates. If lymph nodes are clinically or microscopically positive, adjuvant radiotherapy is indicated to decrease the risk of regional recurrence. The majority of locoregional recurrences occur at the edge or just outside of the radiation field, reflecting both the inherent radiosensitivity of MCC and the importance of relatively large volumes to include “in-transit” dermal lymphatic pathways. When surgical excision of the primary or nodal disease is not feasible, primary radiotherapy alone should be considered as a potentially curative modality and confers good loco-regional control. Concurrent chemoradiotherapy is well tolerated and may further improve outcomes.

scholarly journals Study on nodal metastasis in neck

1970 ◽  
Vol 14 (1) ◽  
pp. 15-22
Author(s):  
SM Mesbah Uddin Ahmad ◽  
AHM Zahurul Huq ◽  
Md Abul Hasnat Joarder ◽  
Abrar Ahmed ◽  
Hasanur Rahman
Keyword(s):  
Primary Tumour ◽  
Cross Sectional Study ◽  
Nodal Metastasis ◽  
Age Group ◽  
Sectional Study ◽  
Upper Aerodigestive Tract ◽  
Single Node ◽  
Neck Node ◽  
Cross Sectional ◽  
Level Ii

A cross sectional study was done in ENT Department, BSMMU from October 07 to March 08. An attempt has been made to evaluate metastatic neck node clinically. 60 cases were studied. Primary lesion identified in 53 cases (88.33%) and remain undetected in 7 cases (11.67%). Among primary sixty (60) diseases, 43 (81.13%) arises from upper aerodigestive tract which were squamous cell carcinoma & 10 (18.87%) came from thyroid & parotid gland. Commonest primary site was Larynx (36.67%). Majority (55%) of patients were age group 41-60. Unilateral lymph node was involved in 49 cases (81.67%), bilateral in 10 (16.67%), contra lateral in 1 case (1.66%), Single node in 22 (36.67%), Multiple in 38 (63.33%) cases. Size of the node >6cm was found in 24 cases (40%), 3-6cm in 20 cases (63.33%), <3cm in 16 cases (26.67%). Most of the involved nodes were in level- II. Key words: Metastatic neck node, primary tumour  DOI: 10.3329/bjo.v14i1.3275 Bangladesh J of Otorhinolaryngology 2008; 14(1) : 15-22

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