Objective: to evaluate the efficacy of the selective neck dissection in the
management of the clinically node-negative neck.
Study Design case histories were evaluated retrospectively.
Methods the results of 75 neck dissections performed on 52 pat
ients were studied.
Results theprimarysites were oral cavity 20, oropharynx 7, hypopharynx 4, and
latynx 21.
14 necks (23%) were node positive on pathological examination. The number of
positive nodes varied from 1 to 9 per side. Of necks with positive 4 (24%) had
extracapsular spread. The median follow up was 24 months. Two recurrences developed
outside the dissected field. The incidence of regional recurrences was similar in patients in
whom nodes were negative on histological examination 3% when compared with patients
with positive nodes without extracapsular spread 4%. In contrast regional recurrence
developed in 18% of necks with extracapsular spread. This observation was statistically
significant. Patients having more than two metastatic lymph nodes had a higher incidence
of recurrent disease than the patients with carcinoma limited to one or two nodes.
Conclusion SND is effective for controlling neck disease and serves to detect
patients who require adjuvant therapy.
