Incidence of Lymphatic Metastasis to Neck Nodes Level IIb in Neck Dissection for Head and Neck Cancers: A Retrospective Study

Abstract

Introduction: Selective neck dissection (SND) is performed to prevent head and neck cancers metastasis. We tried to determine the incidence of level IIb lymph nodes metastasis and it is associations in head and neck cancers for selection of patients requiring SND. Materials and methods: A retrospective study was conducted on 57 patients who underwent surgical removal of the head and neck tumor by 84 neck dissections. Fisher exact test was used to measure the association between positive IIb nodes and the other variables. Results: Nine (15.8%) of 57 patients showed level IIb lymph nodes metastasis comprising 10.71% of the 84 neck dissections. Six (66.66%) were associated with oral cavity cancers, 8 (88.9%) with squamous cell carcinoma (SCC), 6 (66.66%) with T4 tumor. Five (55.6%) were N2b, and 7 (77.8%) were found in N+ necks. All (100%) positive IIb nodes were associated with metastatic level IIa. Significant associations were found between positive IIb nodes and N2b (p = 0.005), clinically N+ necks (p = 0.005) and IIa (p <0.01). Conclusion: The incidence of level IIb nodes metastasis is high so they should be removed in any oral tumor, scc, advanced staging, N+ necks or positive IIa lymph nodes metastasis.