Involvement of Level I Neck Lymph Nodes and Submandibular Gland in Laryngeal and/or Hypopharyngeal Squamous Cell Carcinoma

Abstract Objective: To investigate the prevalence of level I neck lymph node metastases or submandibular nodal metastases in laryngeal and/or hypopharyngeal squamous cell carcinoma (SCC). Patients and Methods: One hundred fifty consecutive neck dissection specimens from 100 patients with laryngeal and hypopharyngeal SCC, who were treated at our institution between 1992 and 2002, were retrospectively reviewed. Results: The tumour stage was T1-T4, and the neck stage was N0-N3. Metastases were never found in level I (Ia + Ib) or in the submandibular gland. Metastases were concentrated within the jugular chain (levels II-IV in 92.2% of the N-positive necks). Conclusion: Metastases of level I of the neck and the submandibular gland are extremely rare in cases of laryngeal and/or hypopharyngeal carcinoma. The risk of facial or hypoglossal nerve injury does not justify the dissection of level I and of the submandibular gland in this type of tumour