SUPRAOMOHYOID NECK DISSECTION

BACKGROUND: Supraomohyoid neck dissection (SOHND) has assumed increasi ng importance as a staging lymphadenectomy in patients with N-o oral a nd oropharyngeal squamous cell carcinoma (SCC), as well as a potential ly curative procedure in selected patients with limited metastatic dis ease in the neck. METHODS: Retrospective chart review of 287 patients who had a total of 320 SOHND for SCC between 1986 and 1993 as a follow -up to an earlier report that covered our experience between 1980 and 1985. After excluding 24 patients who also had local recurrence, or a new primary, the remaining 296 SOHND were assessed for the effectivene ss of tumor control in the neck. RESULTS: Of 248 elective SOHND, clini cally negative nodes proved histologically positive in 60 patients (25 %), only 4 of whom failed in the neck (7%). A total of 48 patients (16 %) had a therapeutic SOHND for limited N+ disease, confirmed pathologi cally in 31, with neck recurrence documented in 2 (6%). Nodes proved n egative histologically in 205 patients, 10 of whom failed in the neck (5%), Nine of the 16 patients with neck recurrence had received postop erative radiation therapy and 9 recurred within the field of the SOHND . CONCLUSIONS: SOHND is a reliable staging procedure in patients with N-o oral or oropharyngeal SCC. Therapeutic SOHND, in conjunction with postoperative radiation therapy, was highly effective in controlling n eck metastases in carefully selected patients with limited disease in the upper neck. (C) 1996 by Excerpta Medica, Inc.