• Title/Summary/Keyword: neck dissection

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Is Prophylactic Central Node Dissection Omissible? (갑상선유두상암에서 예방적 중심경부림프절제술은 생략할 수 있는가?)

  • Shin, Sung-Chan;Lee, Byung-Joo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.1-7
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    • 2018
  • Papillary thyroid carcinoma has a good prognosis, but the frequency of locoregional lymph node metastasis is high and is known to occur stepwise fashion. Prophylactic central node dissection in papillary thyroid carcinoma is widely performed from the past. But, the pros and cons of the prophylactic central node dissection has been ongoing for a long time. In the American Thyroid Association management guideline for thyroid nodules and differentiated thyroid cancer, which is the most widely used, recommendations about prophylactic central node dissection has been changed in past ten years. In recent systematic review and meta-analysis, prophylactic central node dissection increases the rate of transient hypocalcemia and recurrent laryngeal nerve injury, but there is no difference in the frequency of permanent hypocalcemia or recurrent laryngeal nerve injury. Prophylactic central node dissection has not been shown to improve patient survival, but recurrence has been reported to decrease. According to a questionnaire survey of the members of Korean Scociety of Thyroid-Head and Neck Surgery, Korean doctors tend to perform the prophylactic central node dissection more aggressively than other countries. The reason for this is that Korea has a large number of thyroid surgeries and therefore surgeons are more experienced than other countries.

Mono-bloc Dissection of Parotid Gland and Neck with Preserving the Facial Nerve (안면신경을 보존하며 이하선과 경부청소술 시료를 일괴로 절제하는 방법)

  • Choi Eun-Chang;Koh Yoon-Woo;Choi Jae-Jin;Chung Sang-Ho;Hong Hyun-Jun;Moon In-Suk
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.187-190
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    • 2000
  • Parotidectomy, combined with neck dissection, is not rare situation in case of parotid malignancy. It is common to accomplish the parotidectomy and neck dissection separately. But there are numerous lymph nodes surrounding the marginal mandibular branch of facial nerve and facial artery and vein. And so, Mono-bloc dissection of the parotid gland and neck specimen is neccessary to completely resect these lymph nodes with preserving the marginal mandibular branch of facial nerve. We are reporting three cases of mono-bloc dissection of the parotid gland and neck specimen.

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Unexpected Lymph Node Pathology in Neck Dissection for Head and Neck Cancer (두경부 종양환자에서 경부 림프절의 예기치 않은 병리적 소견)

  • Oh Kyung-Kyoon;Lee Guk-Haeng;Lim Sang-Moo;Shim Yoon-Sang
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.3-6
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    • 1994
  • Neck dissection has become an integral part of the staging and management of head and neck tumors. This paper reports a series of head and neck patients who had pathological findings in their neck dissection specimens, which were unrelated to their primary tumors. In 7 cases, there was unexpected pathology in the cervical lymph nodes which was not related to the primary tumor. Four cases were squamous cell carcinomas and 3 were thyroid carcinomas. In 3 cases of squamous cell carcinomas, there were no evidence of metastatic squamous cell carcinoma in neck dissection specimen; however, the lymph nodes were found to be involved by metastatic papillary carcinoma in one larynx cancer, metastatic adenocarcinoma in the other larynx cancer, tuberculosis in one nasopharynx cancer. In three of neck dissection specimen of carcinoma(two thyroid carcinomas, one laryngeal carcinoma), dual nodal pathology was found: Each of these specimen contained carcinoma with tuberculosis of the lymph nodes in three cases. In one thyroid carcinoma, there was no evidence of metastasis; however, the lymph nodes were found to be involved by tuberculosis. Preoperative assessment did not reveal any findings to alert us to the possibility of a synchronous pathological process in the cervical nodes of this group of 7 patients. In particular, there was no evidence of active pulmonary tuberculosis in the 5 patients with active lymph node disease.

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NECK DISSECTION OF CLINICALLY NO NECK OF ORAL SQUAMOUS CELL CARCINOMA & PATHOLOGIC COMPARISON (구강편평세포암종에서 임상적 N0 경부의 경부 곽청술 후 병리학적인 비교)

  • Kang, Jin-Han;Ahn, Kang-Min;Lee, Sang-Woo;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.591-596
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    • 2007
  • Neck node metastasis of oral cancer can be diagnosed by bimanual palpation, CT, MRI and neck sonography and the final diagnosis can be confirmed by pathologic evaluation of the neck nodes after elective neck dissection. When we meet clinically negative neck node(N0 neck) of oral squamous cell carcinoma, the treatment modality of the neck nodes with the primary lesions are so controversial. The usually used methods are various from close observation to elective radiation and elective neck dissection. The methods can be chosen by the primary size of the carcinoma, site of the lesions and the expected percentage of the occult metastasis to the neck. We reviewed the 86 patients from 1996 to 2006 who were diagnosed as oral squamous cell carcinoma, whose necks were diagnosed negative in radiographically and clinically. According to TNM stage, the patients were in the states of N0 and treated by surgery using mass excision and elective neck dissection. We compared the differences between the clinical diagnoses and pathologic reports and would discuss the needs for elective neck dissection.

Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

  • Li, Xiao-Ming;Di, Bin;Shang, Yao-Dong;Tao, Zhen-Feng;Cheng, Ji-Min;He, Zhan-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4273-4278
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    • 2013
  • Objective: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. Methods: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Results: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. Conclusions: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

Functional Evaluation of Spinal Accessory Nerve and Shoulder after Neck Dissection (경부청소술 후 어깨 및 척수 부신경의 기능평가)

  • Tae Kyung;Han Jang-Hee;Park In-Beom;Jeong Jin-Hyeok;Lee Hyung-Seok;Choi Ki-Sub
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.161-166
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    • 2004
  • Objective: The aim of this study is to evaluate shoulder function and preoperative and postoperative electrophysiological changes related to the spinal accessory nerve with reference to neck dissection technique. Materials and Methods: We evaluated shoulder function by pain, strength and range of motion in a total of 35 neck dissection cases of 29 patients with head and neck cancer or thyroid papillary cancer. Electrophysiologic studies were performed before surgery, after third postoperative weeks and 6 months respectively. The results of each test according to the types of neck dissection were compared. Results: Clinical parameters of shoulder function and electrophysiologic study showed deterioration in early postoperative periods and improvements in late postoperative periods when the spinal accessory nerve was spared and permanent nerve damage was observed in radical neck dissection. There were correlations between the clinical parameters and electrophysiologic studies. Conclusion: The shoulder function after spinal accessory nerve sparing procedure is better than the function after nerve sacrificing procedure.

Validation of the Korean Version of the Neck Dissection Impairment Index in Patients Who Underwent Neck Dissection (경부청소술을 시행한 환자를 대상으로 한 경부청소술 후 장애지수에 대한 한글화 버전 표준화)

  • Lim, Won Sub;Lee, Chang Wook;Lee, Yoon Se;Jo, Min-Woo;Jung, Young Ho;Choi, Seung-Ho;Kim, Sang Yoon;Nam, Soon Yuhl
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.43-50
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    • 2021
  • Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

A Clinical Study of the Elective Neck Dissection (예방적 경부청소술의 임상적 의의에 관한 연구)

  • Kim Myun-Joo;Lee Kwang-Sun;Choi Jong-Ouck
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.10-16
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    • 1991
  • Elective neck dissection (END), provide proper information on nodal status and stage which are significant prognosticator in head and neck cancers with clinically $N_{(0)}$ neck. But there are many controversies for the extents, methods of surgery, moreover, whether normal lymph nodes, local defencer, have to be removed or not. The authors performed 47 END in 39 patients of head and neck squamous cell carcinoma from 1984 to 1989 and a retrospective study of the cases was conducted. Eighteen percent of nodal metastasis and five percent of extracapsular spread were found in END specimens. We concluded that END provide significant information for the management and evaluation of prognosis in head and neck cancer.

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Bilateral Chylothorax after Left Modified Radical Neck Dissection : Two Cases (좌측 광범위 경부 림프절 청소술 후 발생한 양측 유미흉 2예)

  • Shin, Jong-Hyun;Lee, Jan-Dee;Yun, Ji-Sup;Lim, Chi-Young;Nam, Kee-Hyun;Chung, Woong-Youn;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.179-182
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    • 2006
  • Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Early diagnosis of chylothorax is important due to the consequences on metabolic & cardiopulmonary conditions. This present report describes our recent experiences with two cases of bilateral chylothorax following left modified radical neck dissection that was treated successfully by conservative management.

Patterns of Neck Node Metastasis and Bilateral Neck Dissections in Supraglottic and Hypopharyngeal Cancers (성문상부암과 하인두암의 경부전이 양상과 양측 경부청소술의 의의)

  • Lee Hyung-Seok;Tae Kyung;Kim Joo-Mook;Park Joon-Soo;Kim Sun-Kon
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.24-29
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    • 1997
  • Background: Supraglottic and hypopharyngeal regions drain into the upper deep cervical lymph nodes. And bilateral neck node metastasis is frequently occured especially, in the early stage. It influences on the prognosis of above diseases. The prognosis for patients wih supraglottic and hypopharyngeal cancers, although usually poor, has improved by modern imaging technique, better application of treatment modalities, increasing assortment of reconstructive procedures and improved application of radiation therapy. Objectives: This study was designed to obtain objective data about the patterns of neck node metastasis and to identify the necessity of elective bilateral neck dissection. Material and Methods: Twenty four patients with supraglottic cancer and twenty six patients with hypopharyngeal cancer were investigated from the chart review. Results: In supraglottic cancer, the most frequent sites of neck metastasis is level II (52.9%) and level III (52.9%) in ipsilateral side, level II (29.4%) in contralateral side, in hypopharyngeal cancer, level II (73.7%) and III (52.6%) in ipsilateral side, level II (10.5%) in contralateral side. In elective neck dissection, the occult metastasis is about 50% in supraglottic cancer, but there is no occult metastasis in hypopharyngeal cancer. Conclusion: In supraglottic cancer, elective bilateral neck dissection is necessary because of early contralateral neck metastasis, but in hypopharyngeal cancer, elective contralateral neck dissection may not be always necessary because of rare occult metastasis and contralateral neck metastasis.

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