Extent of neck dissection following transoral robotic surgical resection of oropharyngeal squamous cell carcinoma: A report of a case and potential indications for inclusion of level i in a selective neck dissection (original) (raw)

Head & neck, 2014

Abstract

Background With new minimally invasive surgical techniques playing a role in the management of early oropharyngeal carcinomas, appropriate surgical management of the neck is an increasingly important consideration. Methods We present a case of a 47-year-old patient with a clinical T2N1M0 squamous cell carcinoma of the right tonsil with anterior extension towards the floor of mouth from the right glossotonsillar sulcus. Imaging revealed a solitary necrotic lymph node in IIA. The decision was made to proceed with a transoral robotic pharyngectomy and selective neck dissection (SND) of levels II-IV, followed by adjuvant radiotherapy. Results A post-operative scan revealed progressive regional disease in the anterior aspect of level IB, and, as such, a completion neck dissection of level I was performed. Conclusion Special consideration must be given to level I particularly in patients with glossotonsillar sulcus involvement and anterior extension towards the floor of mouth. This articl...

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