Usman Ahmed, Riaz Akhtar, Amannat Khan, Muahmmad Ajmal, Amna Usman.
N0 neck treatment in cases of oral cavity carcinoma: Supraomohyoid or extended supraomohyoid neck dissection?.
Rawal Med J Jan ;33(1):95-7.

Objective: To determine the pattern of lymph node metastasis to various groups in the neck in cases of oral cavity carcinoma and the most conservative neck dissection required in oral cavity cancer Patients and Methods: It was a hospital based descriptive study carried out at Pakistan Institute of Medical Sciences, Islamabad, and POF Hospital, Wah Cantt from December 2000 to July 2007. Untreated carcinoma of oral cavity not crossing midline having N0 neck were included in the study. Method of sampling was purposive. The tumors size more then T3 and less than T2 were excluded. All patients had ipsilateral type III modified Radical Neck dissection (Functional Neck Dissection) and lymph node groups had histopathology. Data were analyzed using SPSS computer package. Results: Occult metastases were found in 12 out of 37 (32.4%) cases. There were 14 cases of tongue, 18 of lower alveolar ridge, 2 of floor of mouth and I of buccal mucosa. The levels of lymph nodes involved were level I (16.7%), level II (83.3%), level III (75.5%) and level IV (16.7%). Conclusion: Metastasis in the neck in cases of clinically negative lymph node is common. Level I, II, III and IV are involved. It is advisable to have extended supraomohyoid neck dissection with the removal of level I, II, III and IV rather than supraomohyoid neck dissection alone. (Rawal Med J 2008;33:95-97).

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