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Introduction <p>There is high prevalence of oral cancers in our region due to tobacco quid chewing. Majority of patients present with loco- regionally advanced disease requiring composite resection, neck dissection and adjuvant treatment. Some patients can have lymphatic spread to supra mandibular facial lymph nodes (SMFLN) along the facial vessels particularly if submandibular lymph nodes harbor metastasis. In conventional neck dissection SMFLN are not resected as their involvement is uncommon and their clearance risks marginal mandibular nerve (MMN) injury. Recurrence in SMFLN results in regional failure. We analyzed frequency of SMFLN involvement in oral squamous cell carcinoma (OSCC) and outcome of their clearance and complications.</p> Objectives <p>To analyze SMFLN by histopathology for metastasis in oral cancers with palpable cervical lymph nodes.</p> Methodology <p>This study involved 97 patients undergoing Composite resection and neck dissection for OSCC with palpable cervical lymph node. SMFLN were harvested during surgery and analyzed by histopathology for metastasis. MMN injury was documented.</p> Results <p>20(20%) out of 97 patients had SMFLN micro-metastasis. Among them 12/69(17.3%) patients had primary lesion in the buccal mucosa, 4/13(30.7%) had in alveolus, 3/8(37.5%) had lesion in RMT and 1/4(25%) had in tongue. MMN neuropraxia was seen in 2 (2%) patients and recovered in 3&#xa0;months. There was no permanent paralysis observed expect in 6 patients (6%) for whom MMN was intentionally sacrificed due to macroscopic involvement with SMFLN.</p> Conclusion <p>SMFLN can harbor metastasis in 20% of oral cancers and need to be cleared when submandibular lymph nodes are present. The procedure has low incidence of MMN injury.</p>

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Evaluation of Supra Mandibular Facial Lymph Nodes for Metastasis in Oral Cavity Cancers with Palpable Cervical Lymph Nodes

  • 期刊论文

  • 发表日期：

    2025年7月7日

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  • Kunal Thakur,
  • S. M. Azeem Mohiyuddin,
  • R. K. Karnika,
  • M. L. Harendra Kumar,
  • Merchant Shuaib,
  • Manaswini Ramachandra,
  • M. Sri Vani Chandana

摘要

Introduction

There is high prevalence of oral cancers in our region due to tobacco quid chewing. Majority of patients present with loco- regionally advanced disease requiring composite resection, neck dissection and adjuvant treatment. Some patients can have lymphatic spread to supra mandibular facial lymph nodes (SMFLN) along the facial vessels particularly if submandibular lymph nodes harbor metastasis. In conventional neck dissection SMFLN are not resected as their involvement is uncommon and their clearance risks marginal mandibular nerve (MMN) injury. Recurrence in SMFLN results in regional failure. We analyzed frequency of SMFLN involvement in oral squamous cell carcinoma (OSCC) and outcome of their clearance and complications.

Objectives

To analyze SMFLN by histopathology for metastasis in oral cancers with palpable cervical lymph nodes.

Methodology

This study involved 97 patients undergoing Composite resection and neck dissection for OSCC with palpable cervical lymph node. SMFLN were harvested during surgery and analyzed by histopathology for metastasis. MMN injury was documented.

Results

20(20%) out of 97 patients had SMFLN micro-metastasis. Among them 12/69(17.3%) patients had primary lesion in the buccal mucosa, 4/13(30.7%) had in alveolus, 3/8(37.5%) had lesion in RMT and 1/4(25%) had in tongue. MMN neuropraxia was seen in 2 (2%) patients and recovered in 3 months. There was no permanent paralysis observed expect in 6 patients (6%) for whom MMN was intentionally sacrificed due to macroscopic involvement with SMFLN.

Conclusion

SMFLN can harbor metastasis in 20% of oral cancers and need to be cleared when submandibular lymph nodes are present. The procedure has low incidence of MMN injury.