Cervical Lymphadenectomy

8/2/2019 Cervical Lymphadenectomy

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CERVICALLYMPHADENECTOMY



Lymphadenectomy is the surgical

removal of one or more groups of lymph nodes. It is almost always

performed as part of the surgical

management of cancer. In thetreatment of head and neck cancer,

three areas must be addressed: the

primary site, the neck, and sites of

distant metastasis. Of these, disease in

the neck is the least straightforward.



http://www.evmsent.org/neck_dissection.asp



level IIb: Submuscular recess

Superior : Skull base

Inf erior : Carotid bifurcation (surgical) or inferior border

of hyoid bone (radiologic)

Lateral : Posterior border of sternocleidomastoid

Medial : Spinal accessory nerve (surgical) or medial

border of internal carotid (radiologic)

Clinical Significance

Dissection of this group involves significant risk for

shoulder dysfunction.

In the absence of nodal disease in level IIa, it is not

necessary to include level IIb for cancers of the oral

cavity or larynx.



level III: Midjugular

Superior : Carotid bifurcation (surgical) or inferior

border of hyoid bone (radiologic)Inf erior : Omohyoid muscle (surgical) or inferior

border of cricoid (radiologic)

Lateral : Posterior border of sternocleidomastoid

Medial : Sternohyoid muscle (surgical) or medialborder of common carotid (radiologic)

Clinical Significance

There is a risk of malignancy from the oral cavity,

nasopharynx, hypopharynx, and larynx.



http://www.imaios.com/en/e-Anatomy/Thorax-Abdomen-

Pelvis/Lymph-nodes-CT



http://www.aafp.org/afp/2002/1201/p2103.html



http://thefosti.kilu.de/



Region Of Pharynx

http://quizlet.com/2554906/gi-system-flash-cards/



1. Nasopharynx

- Nose open to the nasopharynx through choanae

- Roof and posterior wall are lined inferior to the body of

sphenoid bone and basilar part of the occipital bone

- contains pharyngeal tonsil (adenoid) at the mucous of the

roof and posterior wall

- Lateral wall contains pharyngotympanic tube and

salpingopharyngeal fold (salpingopharyngeus muscle) and

tubal tonsil and pharyngeal recess



2.Oropharynx

http://biology.clc.uc.edu/fankhauser/labs/microbiology/strep_detection/strep_test.htm



-Bound by soft palate, tongue and

palatoglossal and

palatopharyneal arches

- Function in the deglutition (swallowing)

- Contains palatine tonsil



3. laryngopharynx



- Extends from the superior border of the epiglottis and

pharyngoepiglottic folds to the inferior border of the cricoid

cartilage

- Posterior and lateral wall are line by middle and inferior

constrictor muscles and palatopharyngeus and

stylopharyngeus

- piriform recess (fossa) = a small depression of the laryngeal

cavity on each side of the laryngeal inlet

Cervical Lymphadenectomy

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