Neck dissection is performed to either address the nodal basin in the neck for malignancies of oral cavity, salivary glands, skin or access the neck vessels for reconstruction. It is performed either electively or selectively to improve the disease free survival. It is known that the morbidity associated with selective procedures is less and there is increased trend to perform selective neck dissection in appropriate cases. Preservation of submandibular gland improves symptoms of xerostomia.We performed a retrospective study of all the neck dissections spanning over 20 years in our institution. This was undertaken to find out if it is oncologically safe to leave submandibular gland. We looked at the indication of the neck dissection and histological analysis specifically looking at the extra capsular spread and the submandibular gland involvement. In a pilot study of 151 neck dissections the incidence of submandibular gland involvement was 5.9%. Direct invasion through extra-capsular spread was the mode in all these cases. No skip metastasis was observed in the submandibular gland thereby re-emphasising the hypothesis. We present the completed study and our conclusions.
Can we preserve the submandibular gland in neck dissections?
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