Lymphatics of the mouth and neck

Larson, Duane L.; Lewis, S. R.; Rapperport, Alan; Coërs, Christian; Blocker, T. G.

doi:10.1016/0002-9610(65)90051-6

Cited by 35 publications

(11 citation statements)

References 8 publications

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“…Advanced ipsilateral neck disease may not independently increase the risk of contralateral disease recurrence. For example, to the best of our knowledge, anatomic and lymphatic mapping studies have not identified connections between opposite lymph node regions I to IV of the neck . Therefore, it may be that contralateral lymph node disease occurs because the primary tumor approaches the midline, resulting in contralateral metastasis, or because the tumor invades a region with extensive submucosal lymphatics such as the tongue or floor of the mouth .…”

Section: Discussionmentioning

confidence: 99%

Comparison of unilateral versus bilateral intensity‐modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil

Chin

Rao

Hwang

et al. 2017

Cancer

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Section: Discussionmentioning

confidence: 99%

Comparison of unilateral versus bilateral intensity‐modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil

Chin

Rao

Hwang

et al. 2017

Cancer

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“…Other investigators have observed qualitative differences in the lymphatics of the upper aerodigestive tract. Larson et al 36 in a dog study designed to characterize collateral lymphatic flow demonstrated both fine and large‐caliber lymphatics in the tongue. Shoaib et al 33 recommended that different radiotracers be used depending on the mucosal site to be studied.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy in Head and Neck Squamous Cell Carcinoma

et al. 2002

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“…It is based on the predictable pattern of distribution of lymph node metastases in the neck. These patterns have been delineated through careful anatomic studies of the lymphatic drainage for different sites of the head and neck [6][7][8] and also through clinical studies of this distribution. [9][10][11][12][13][14][15][16] Many reports [17][18][19][20][21][22][23][24][25] have also shown the effectiveness of less radical procedures such as SOHND and LND as elective or therapeutic procedures compared with radical neck dissection considering the regional recurrence.…”

Section: Commentsmentioning

confidence: 99%

“…It is based on the predictable pattern of distribution of lymph node metastases in the neck. These patterns have been delineated through careful anatomic studies of the lymphatic drainage for different sites of the head and neck [6][7][8] and also through clinical studies of this Apex(+)/level h (+), number of neck dissections with positive metastases at the referred level (level h (+)) with positive metastases at the apex (Apex(+)) on the basis of histopathologic evaluation; Apex(+)/level h (−), number of neck dissections with negative metastases at the referred level (level h (−)) with positive metastases at the apex (Apex(+)) on the basis of histopathologic evaluation. *No test was applicable for level IA.…”

Section: Commentsmentioning

confidence: 99%

“…Selective neck dissections such as SOHND and LND include the lymphatic pad of the APEX. There is no generally accepted nomenclature for these lymph nodes and they were called "junctional" nodes by Fisch and Sigel, 29 upper posterior cervical nodes by Lindberg 11 , upper spinal accessory nodes by O'Brien et al, 30 supraspinal lymph nodes by Kraus et al, 31 and level IIb by Byers et al 32 These lymph nodes drain the skin of the head and neck, nasal cavity, and nasopharynx [6][7][8] and drain to jugular and spinal accessory nodes. 29 There is no primary drainage from the oral cavity, oropharynx, larynx, or hypopharynx to them.…”

Section: Commentsmentioning

confidence: 99%

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Neck lymph node metastases to the posterior triangle apex: Evaluation of clinical and histopathological risk factors

Chone¹,

Crespo²,

Rezende³

et al. 2000

Head Neck

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Background Dissection of posterior triangle apex (APEX) is a surgical step in supraomohyoid and lateral neck dissections. The prevalence of lymphatic metastases at this site and the clinicohistopathologic conditions that influence their occurrence have not been established. We have evaluated the prevalence and the risk factors for cervical metastases in lymph nodes of the APEX. Methods Sixty‐two neck dissections were performed in 51 patients with squamous cell carcinoma of the oropharynx, hypopharynx, oral cavity, glottic larynx, and supraglottic larynx or with primary occult tumor. We correlated the presence of positive metastases in the APEX with the neck level involved either clinically (CLIN) or histopathologically (H/P) and with the number of CLIN‐ or H/P‐positive neck levels with metastases. The prevalence of metastases in the APEX in elective (N0) and therapeutic (N+) neck dissections was also compared. This prevalence was also compared with that for each neck level. The histopathologic comparisons between the APEX and the neck levels were calculated for N0, N+, and all neck dissections. The primary site of tumor was correlated with the presence of H/P‐positive nodes in the APEX. Results The overall prevalence of lymphatic metastases in the APEX was 6.5%. The prevalence in N0 neck dissections was 2.3% and in N+ neck dissections it was 16.7%. The prevalence of lymphatic metastases in the APEX for primary tumors of pharynx was 23.1%, for the oral cavity it was 3.6%, and it was 0% for other sites. Metastases in the APEX were not influenced by the neck level with CLIN or H/P metastases in N+ necks. The number of CLIN‐ or H/P‐positive neck levels had no influence on histopathologic metastases in the APEX. Factors that influenced metastases in the APEX were positive histopathologic metastases at level II for N0 neck dissections and positive histopathologic metastases at level II or III for all neck dissections. All the comparisons were analyzed using Fisher's or Poisson's test. Conclusions The prevalence of histopathologic metastases in the APEX in N+ necks is 7.3 times greater than that of N0 necks and for primary tumors of pharynx it was 6.4 times greater than for the oral cavity and significantly greater than for the larynx. Histopathologic metastases at level II for clinically N0 necks and histopathologic metastases to level II or III for all neck dissections are risk factors for metastases in the APEX. The number of positive levels did not influence the prevalence of metastases in the APEX. There are no isolated metastases in the APEX of the posterior triangle. © 2000 John Wiley & Sons, Inc. Head Neck 22: 564–571, 2000.

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Lymphatics of the mouth and neck

Cited by 35 publications

References 8 publications

Comparison of unilateral versus bilateral intensity‐modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil

Comparison of unilateral versus bilateral intensity‐modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil

Sentinel Lymph Node Biopsy in Head and Neck Squamous Cell Carcinoma

Neck lymph node metastases to the posterior triangle apex: Evaluation of clinical and histopathological risk factors

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