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TITLE: Neck Dissection and Sentinel Lymph Node Biopsy SOURCE: Grand Rounds Presentation, UTMB, Dept. ... - page 6 / 9

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Regional Lymph Nodes (N)

Lip, oral cavity, oropharynx, hypopharynx, larynx, trachea, paranasal sinuses, major salivary glands,

Nx - Regional lymph nodes cannot be assessed N0 - No regional lymph node metastasis N1 - Single ipsilateral lymph node 3-6 cm N2

N2a Single ipsilateral lymph node 3-6 cm N2b Multiple ipsilateral nodes < 6 cm N2c Bilateral lymph nodes < 6 cm N3 - Any node > 6 cm

Nasopharynx

Nx - nodes cannot be assessed N0 - no regional lymph node metastasis N1 - Unilateral metastasis in lymph nodes < 6 cm above the supraclavicular fossa N2 - Bilateral metastasis in lymph nodes < 6 cm above the supraclavicular fossa N3 - Metastasis in a lymph node(s)

N3a > 6 cm N3b extension to the supraclavicular fossa

Thyroid

Nx - Regional lymph noses cannot be assessed N0 - No regional lymph node metastasis N1 - Regional lymph node metastasis

  • N1a - Metastasis in ipsilateral cervical lymph node(s)

  • N1b - Metastasis in bilateral, midline, or contralateral cervical or mediastinal

lymph node(s)

Classification

In order to communicate effectively between institutions and compare data related to surgical procedures, a classification scheme for neck dissections has been endorsed by the American Society for Head and Neck Surgery. The nomenclature uses the radical neck dissection as the standard which all other modifications are compared to. Preservation of any combination of the IJV, SCM or XI is a modified radical neck dissection (MRND). Preservation of lymphatic groups normally removed in a RND is a selective neck dissection. An extended neck dissection removes any structure or additional lymph node groups normally preserved in a RND.

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