MANAGEMENT OF PARATRACHEAL LYMPH NODES IN RADICAL NECK DISSECTION

Abstract

The cervical lymphatic system consists of : (1) the deep cervical lymphatic system along the jugular vein : (2) the superficial cervical lymphatic system along the accessory nerve : and (3) the paratracheal lymphatic system along the recurrent laryngeal nerve. The aim of the neck dissection is, as a matter of course, to excise completely these cervical nodes which already have had or may possibly come to have metastasis, for the removal of carcinoma.The routine technique of the neck dissection is the excision en bloc of the deep cervical and the superficial lymphatic nodes together with their adjacent tissues : the paratracheal lymphatic nodes seem not to be included in this range of excision. This is because of the lower incidence of metastasis in the paratracheal nodes. However, in some cases, it may be contract to the aim of neck dissection. Then, in what situations should the paratracheal nodes be excised? This problem is the main theme of the present paper.