Fareya Usmani, Syed Mosaddaque Iqbal, Syed Iqbal Hussain, Mukhtar Ibrahim, Imran Munir, Sohail Tirmizi.
Role of Neck dissection in early carcinoma oral tongue with NO neck.
Pak J Surg Jan ;36(3):227-31.

Background & Objective: Amongst head and neck malignancies, tongue is the second commonest site. This study aims at efficacy of elective neck dissection in management of early carcinoma oral tongue without neck involvement clinically. This study focuses on lymph node metastasis in early carcinoma oral tongue, its management and prognosis. Material and Methods: This cross-sectional study included the patients presenting from June 2005 to June 2019 retrospectively at Jamal Noor Hospital, Karachi. Total 47-patients were included who presented with early squamous carcinoma oral tongue with no stage (no neck involvement clinically). Patients with metastatic disease were excluded. They were treated by wide local excision (hemi-glossectomy) and elective neck dissection. The biopsy report was studied for histo-pathological evidence of metastasis. Data analyzed by SPSS. Results: Amongst the 47 cases, 16-patients had T1 while 31 had T2 lesion. Out of 16 cases of T1 lesion; 4(25%) patients had nodal metastases, while amongst 31-patients with T2 lesions 10(32%) patients had nodal metastases. The skip lesion metastases were observed in 01(6%) case to the level III. Metastasis to the level IV & V were not seen in any case. Conclusions: The lymph node metastasis in 31% patients of early carcinoma oral tongue with no clinical involvement of neck supports the role of elective neck dissection. The supraomohyoid neck dissection seems to be a safe and effective option. Level IV and V metastasis was less likely seen in such cases. However, neck dissection should include IV and V levels if per-operative extensive metastases is seen in levels II and III.

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