Feasibility of submandibular gland preservation in neck dissection: A prospective anatomic-pathologic study

Muthuswamy Dhiwakar, Ohad Ronen, James Malone, Krishna Rao, Stephen Bell, Roy Phillips, Bruce Shevlin, K. Thomas Robbins

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Background. The submandibular gland is commonly removed during neck dissection involving sublevel IB. However, removal reduces basal salivary secretion and therapeutic options for minimizing xerostomia. The purpose of this study was to determine whether all lymph nodes in sublevel IB can be extirpated without removing the submandibular gland. Methods. Twenty consecutive patients undergoing 33 neck dissections were prospectively enrolled. Sublevel IB dissection was performed by 3 sequential steps: (1) removal of targeted lymph node groups (preglandular and postglandular, prevascular and postvascular), (2) removal of submandibular gland, and (3) removal of residual lymphoadipose tissue in the surgical bed. Results. Complete removal of lymph nodes in sublevel IB was achieved before excising the submandibular gland in all of the 30 eligible neck dissections. The submandibular gland and the surgical bed contained no residual lymph nodes. Conclusion. In suitable cases, it is technically feasible to remove all lymph nodes in sublevel IB and preserve the submandibular gland.

Original languageEnglish
Pages (from-to)603-609
Number of pages7
JournalHead and Neck
Volume33
Issue number5
DOIs
StatePublished - May 2011
Externally publishedYes

Keywords

  • level I lymph nodes
  • neck dissection
  • organ preservation
  • submandibular gland
  • xerostomia

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