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12. Indications for Neck Dissection with Hypopharyngeal Cancers

  • Page ID
    18397
    • Unlike glottic cancer, hypopharyngeal cancers have a high propensity for
      • Occult cervical nodal metastases
      • Paratracheal nodal metastases (Level VI)
      • Bilateral nodal metastases
    • T1 (most) and T2-4 clinically N0 neck
      • Elective neck dissection Levels II– IV
      • Level VI (pre- and paratracheal nodes).…requires thyroid lobectomy
      • Contralateral SND Levels II– IV
        • Medial wall of piriform fossa / aryepiglottic fold
        • Postcricoid
        • Posterior pharyngeal wall
      • Convert to MND if suspicious nodes in neck (+/- frozen section)
      • Level VI (pre- and paratracheal nodes) with subglottic extension or extension to piriform fossa…requires thyroid lobectomy
    • Clinically N+ neck
      • Modified radical neck dissection (MND) / Radical neck dissection (RND)
      • Contralateral END Levels II– IV
        • Medial wall of piriform fossa / aryepiglottic fold
        • Postcricoid
        • Posterior pharyngeal wall