口腔, 上顎洞の扁平上皮癌に対する内頸静脈, 副神経を保存した頸部郭清術の治療成績

概要

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Neck dissection in which the sternocleidomastoid muscle was excised and the internal jugular vein and accessory nerve were preserved was performed in 73 patients with squamous cell carcinomas of the oral cavity or maxillary sinus. The dissection was done prophylactically in 54 patients and therapeutically in 19 patients.<BR>Histopathological findings of the neck lymph nodes revealed that the numbers of pN (+), false negative and false positive cases were 22 (30.1%), 12 (22.2%) and 9 (47.4%), respectively. In only one case (1.4%) both recurrence in the ipsilateral neck nodes and late metastasis of the contralateral neck nodes were observed. Only late metastasis of the contralateral neck nodes was noted in three cases. The results obtained by this type of neck dissection were superior to those previously reported for radical neck dissection (RND) suggesting that this operative technique is very useful in patients without infiltration of metastatic vein as well as in patients with no neck node involvement. The technique described was here considered to be significant in that there is no interference of blood brain flow because the internal jugular vein is preserved.