Abstract

Introduction: The single most important factor affecting the prognosis for squamous cell carcinoma of the oral cavity, is the status of the cervical lymph nodes. Metastasis to the regional lymph nodes reduces the 5year survival rate by 50% compared with that of patients with early stage disease. Therefore, management of the cervical lymph nodes is an important component in the overall treatment plan for patients with carcinomas of the oral cavity.

Materials and Methods: During the period of 2017 to 2019 data were collected from patients who attended the General surgical wards of Rajah Muthiah Medical College and Hospital, Chidambaram with suspected metastatic nodes with known primary. In patients who presented with known primary and a metastatic node, the primary was thoroughly examined at its size, shape, gross appearance, consistency were all noted. Then the neck nodes were examined and its site, size, shape, consistency, number, mobility, fixity to skin and deeper structures like carotid artery, muscle and cranial nerve involvement. A lymph node was taken as significant if it was in the drainage area of the primary, hard and above 1 cm in size.

Results: Out of 30 patients included in the study, Male patients were 21 and female patients were 9, which accounts to around 70% and 30% respectively. The Male and female ratio was found as 2.3:1.Maximum age incidence was found as 46-65 years of age. The higher incidence of oral cavity cancers should be attributed to tobacco chewing and alcohol intake.

The commonest site of nodal metastasis was in the upper deep cervical group in 42% (Level II and III)  followed by submandibular group in 27% (Level I), lower deep cervical group in 25% (Level IV) and posterior triangle group in 6% (Level V)

Out of 30 patients with known primary with neck secondaries, 6 Patients were in N1 (22%),14 patients in N2 (46%) and 10 patients in N3 (33%).

Conclusion:  Out of 30 patients included in the study, most common age group requiring Neck dissection is around 46 years and 65 years. Definitive male preponderance was noted. All patients who underwent Radical or Modified Radical Neck dissection for Squamous Cell Carcinoma was treated postoperatively with Radiotherapy. Shoulder Dysfunction was the most common complication of Radical Neck Dissection. No recurrence was found in the mean follow up period of one year.

Keywords: Oral cancers, Oral malignancy, neck dissection, modified radical neck dissection, radical neck dissection.