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TITLE: Neck Dissection and Sentinel Lymph Node Biopsy SOURCE: Grand Rounds Presentation, UTMB, Dept. ... - page 3 / 9

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  • o

    Oral Cavity

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      Floor of mouth

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      Oral tongue

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      Nasal cavity (anterior)

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      Face

Level II: Upper jugular nodes

  • Boundaries

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      Anterior lateral border of the sternohyoid muscle, posterior digastric and stylohyoid

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        Posterior posterior border of the sternocleidomastoid muscle

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        Superior skull base

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        Inferior level of the hyoid bone (clinical landmark) or carotid bifurcation (surgical landmark)

  • Primary drainage

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        Oral Cavity

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        Nasal Cavity

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        Nasopharynx

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        Oropharynx

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        Larynx

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        Hypopharynx

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        Parotid

Level IIa anterior to XI Level IIb (Submuscular recess) - posterior to XI

  • More likely to drain pharyngeal lesions than oral cavity or

laryngeal lesions.

Level III:

Middle jugular nodes

  • Boundaries

    • o

      Anterior lateral border of the sternohyoid muscle

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        Posterior posterior border of the sternocleidomastoid muscles

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        Superior hyoid bone (clinical landmark) or carotid bifurcation (surgical landmark)

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        Inferior cricothyroid notch (clinical landmark) or omohyoid muscle (surgical landmark)

  • Primary drainage

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        Oral cavity

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        Nasopharynx

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        Oropharynx

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        Hypopharynx

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        Larynx

Level IV: Lower jugular nodes

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    Boundaries

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      Anterior lateral border of the sternohyoid muscle

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        Posterior posterior border of the sternocleidomastoid muscles

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