Lymph Nodes of the Perimandibular Area and the Hazard of the Hayes Martin Maneuver in Neck Dissection. (24th April 2018)

• Record Type: Journal Article
• Authors: Tirelli, Giancarlo; Marcuzzo, Alberto Vito
• Is Part Of: Otolaryngology--head and neck surgery. Volume 159:Number 4(2018)
• Page Start: 692
• Page End: 697
• Publication Date: 2018-04-24
• Subjects: neck dissection -- perifacial lymph nodes -- submandibular lymph nodes -- perifacial nodes -- submandibular nodes -- marginal nerve -- marginal mandibular nerve -- Hayes Martin maneuver -- neck metastases -- cervical metastases; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818773084
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objective: To provide an anatomic description of submandibular nodes at risk of being left undissected during neck dissection (ND) and to assess whether the Hayes Martin maneuver is a safe procedure in oncologic surgery of level IB nodes. Study Design: Prospective study. Setting: Academic medical center. Subjects and Methods: We recruited 62 patients who were candidates for level IB ND. Perifacial nodes (PFNs) were identified and their characteristics noted. The Hayes Martin maneuver was simulated, and its oncologic safety was tested. Results: The study included 63 NDs. PFNs were identified in 84% of cases: their number ranged from 0 to 5, and their mean greatest diameter was 12.45 mm. Anterior PFNs were found to be in direct contact with the marginal mandibular nerve. In 59% of NDs, the Hayes Martin maneuver would have failed to remove all PFNs. Conclusions: The PFNs were identified in 84% of cases and ranged in number from 0 to 5. In some cases, the distinction between retro‐ and preglandular nodes and PFNs is not useful. The Hayes Martin maneuver may not be oncologically sound for complete treatment of level IB nodes.