Should Level IIb Be Addressed Routinely in Clinically Node Negative Oral Cancers?

  • Pankaj Chaturvedi
  • Akshat Malik
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)


A conundrum commonly faced by any Head and Neck surgeon is whether to address level IIb in patients with clinically node negative oral cancer. A thorough literature search was conducted evaluating the occult metastasis at level IIb in cN0 neck in oral cavity cancer patients and to assess whether level IIb dissection actually affected the spinal accessory nerve function. Based upon the review we found that occult metastasis at level IIb can occur in oral cavity carcinoma regardless of T stage. These may occur more often in patients with tongue cancer. Though some degree of accessory nerve dysfunction may occur following IIb dissection, it has not been proven to be of clinical relevance.


Oral cancers Neck dissection Level IIb Shoulder dysfunction Selective neck dissection Spinal accessory nerve 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Pankaj Chaturvedi
    • 1
  • Akshat Malik
    • 1
  1. 1.Department of Head and Neck OncologyTata Memorial CentreMumbaiIndia

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