Role of the selective neck dissection of the head and neck carcinomas

Purpose: The aim of study is to investigate the effiency of selective neckdissection on cancer staging and oncologic adequacy of the contribution.Materials and Methods: Patients who operated in between January 1993 andSeptember 2008 in Çukurova University Faculty of Medicine ENT Department wereretrospectively reviewed. Three hundred and fifteen patients who underwent selectiveneck dissection with 24 or more months follow-up periods were included in this study.In case of bilateral neck dissection of 76 patients we totaly evaluate the 391 neckdissection specimens on this study.Results: In the first group, we found 25 (16,1%) occult metatases along 223patients with laryngeal squamous cell carcinoma which were identified clinically N0neck. We have only one patient with supraglottic laryngeal carcinoma who has a neckrecurrence (4%). On specimens of oral cavity carcinoma patients we found 20 (30,7%)occult metastases and three of these patients (15%) has recurrence. On second group,we investigate 82 contralateral selective neck dissection and we found 32 (46,3) occultmetastases in laryngeal carcinoma and 4 (36,3%) occult metastases in oral cavitycarcinoma. None of these patients have recurrence on the neck. On the third group, weperformed 10 selective neck dissection on N1 laryngeal epidermoid carcinoma patients.And 8 of these patients have histologically metastasis and 2 of them were not. None ofthese patients has recurrence on the neck.Conclusion: As a result, in our study we detect the efficiency of selective neckdissection on occult metastases identification with clinically N0 and selected N1 headand neck carcinoma patients. As we see the low and similar rate of recurrence withselective neck dissection and radical neck dissection. We think that selective neckdissection is on oncologically enough and effective treatment modality.Key words: Head and neck squamous cell carcinomas, selective neck dissection,lymphatic metastasis.