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

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Difficult Decisions in Head and Neck Oncologic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

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.

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India

    Pankaj Chaturvedi & Akshat Malik

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  1. Pankaj Chaturvedi
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  2. Akshat Malik
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Editors and Affiliations

  1. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Zhen Gooi

  2. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Nishant Agrawal

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Chaturvedi, P., Malik, A. (2019). Should Level IIb Be Addressed Routinely in Clinically Node Negative Oral Cancers?. In: Gooi, Z., Agrawal, N. (eds) Difficult Decisions in Head and Neck Oncologic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-15123-2_5

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  • DOI: https://doi.org/10.1007/978-3-030-15123-2_5

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-15123-2

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