Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?

Ebrahim, A K; Loock, James; Afrogheh, Amir; Hille, Jos

doi:10.1017/s0022215111001095

Cited by 35 publications

(28 citation statements)

References 15 publications

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“…3 Studies have reported the prevalence of submandibular gland involvement by head and neck carcinoma to range from 0.9% to 5.3%. [4][5][6][7][8] Submandibular gland involvement is most commonly secondary to direct extension from level I nodal disease or direct extension from a primary oral cavity tumor. As a result, the necessity of submandibular gland removal during neck dissection has been questioned.…”

Section: Introductionmentioning

confidence: 99%

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Howard

Hinni

Nagel

et al. 2014

Otolaryngol.--head neck surg.

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Section: Introductionmentioning

confidence: 99%

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Howard

Hinni

Nagel

et al. 2014

Otolaryngol.--head neck surg.

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“…Similar studies have reported metastasis to submandibular gland from an index tumor in head and neck is either very rare or never found [13][14][15][16]. Fibrous capsule surrounding the submandibular gland provides an effective barrier to the spread of squamous cell carcinoma, even when the gland is compressed by bulky metastatic disease [17].…”

Section: Discussionmentioning

confidence: 66%

Questionable Necessity for Removing Submandibular Gland in Neck Dissection in Squamous Cell Carcinoma of Oral Cavity

Agarwal

Nagpure

Chavan

2016

Indian J Otolaryngol Head Neck Surg

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To assess whether submandibular gland is involved by metastasis in cases of oral cavity squamous cell carcinomas. It was a retrospective study, where we reviewed the records of the patients who underwent neck dissections for Squamous Cell Carcinoma of the oral cavity. It included 112 patients who had undergone 115 neck dissections (three patients had undergone bilateral neck dissection), either therapeutic or prophylactic. No pathologic evidence of metastasis to submandibular gland was seen in any of the case. Preservation of submandibular glands can be a good technique for reducing future complications in a patient undergoing Neck Dissection wherever feasible. Therefore, if there is no need to expose large oral cavity tumors through the submandibular triangle, or when there is no direct extension of the primary and/or regional lymph nodes into the submandibular gland, it may be safe to preserve the submandibular gland.

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“…Based on their study findings, the authors thought that it might be feasible and safe to preserve an oncologically sound submandibular gland during neck dissection in patients with early-stage oral cancer [18]. Other studies revealed similar results, demonstrating that submandibular gland metastasis from head and neck primary squamous cell carcinoma was extremely rare and that direct invasion as a primary mechanism of metastasis led to most of the metastases [6, 7, 9, 10]. These studies concluded that preservation of the submandibular gland might be oncologically safe and feasible unless there was evidence of direct invasion of the gland or close proximity of the cancer to it.…”

Section: Discussionmentioning

confidence: 99%

“…However, the involvement of submandibular glands in oral cavity and oropharyngeal cancers is quite rare, especially in early oral cancers [5, 6]. Additionally, the existence of intraglandular lymph nodes within submandibular glands continues to be debated [7, 8]. Studies have demonstrated that preservation of the submandibular gland during neck dissection is oncologically safe in patients with early oral cancers unless the primary tumor or metastatic regional lymphadenopathy is adherent to the gland [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers

et al. 2014

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BackgroundThe growth of aging populations in an increasing number of countries has led to a concomitant increase in the incidence of chronic diseases. Accordingly, the proportion of older aged patients with oral cavity and oropharyngeal cancers and comorbidities has also increased. Thus, improvements must be made in the tolerance and safety of surgical procedures for these patients with complex medical conditions. In this study, we investigated combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers in terms of surgical methods, safety, and clinical outcome.MethodsBetween January 2011 and May 2012, 8 patients over the age of 65 years (7 men, 1 woman; aged 66 to 75 years (median, 69.6)) with oral cavity and oropharyngeal cancers underwent combined submandibular gland and sternocleidomastoid myocutaneous flaps for postoperative reconstruction at Ganzhou Tumor Hospital. All eight patients had comorbid cardiovascular, cerebrovascular, or chronic respiratory disease or diabetes. Clinical outcomes, complications, and tolerance to surgical treatment were observed.ResultsSurgical treatment was successful in all eight patients. All submandibular gland flaps survived with well-mucosalized surfaces and with no complications. During the postoperative follow-up period of 12 to 28 months, no patient developed local recurrence or distant metastasis, and all had good recovery of function and local contour.ConclusionsThis combined reconstruction technique enables appropriate restoration of oral function, facial aesthetics and improved quality of life. Further, this technique has several advantages: it is easier to perform, reduces operation time and surgical risk, causes less surgical injury, and has minor impact on contour. The technique provides a new and safe reconstruction option for older aged patients with oral cavity and oropharyngeal cancers.

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Is it oncologically safe to leave the ipsilateral submandibular gland during neck dissection for head and neck squamous cell carcinoma?

Cited by 35 publications

References 15 publications

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Questionable Necessity for Removing Submandibular Gland in Neck Dissection in Squamous Cell Carcinoma of Oral Cavity

Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers

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