Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of E.N.T

Squamous cell carcinoma of the head and neck accounts for approximately 6% of all new cancers diagnosed yearly, of which, 25% arise on the laryngopharyngeal area, with incidence of lymph node metastases varying from 25% to 65%. The review of literature have shown that 20-30% of laryngopharyngeal cancer patients with a clinical N0 neck harbour occult cervical metastases. Multiple reports showed that dissection of neck level I is justifiable in laryngeal cancer patients with clinically detectable neck nodes and suspicious lymph nodes. However, in patients without clinically detectable neck nodes, preservation of levels I is oncologically safe, economical and reduces the risk of comorbidity. The aim of this work was to investigate the incidence of level I neck lymph node metastases or submandibular gland metastases in advanced laryngeal and/or hypopharyngeal tumors and to assess the post-operative morbidity. In this study, we included 30 patients who had surgical treatment for advanced laryngeal and/or hypopharyngeal tumors, including neck dissection, at the department of otorhinolaryngology, Head and Neck Surgery, Faculty of medicine, Cairo university. According to our statistical analysis and data, none of those thirty patients had pathologically positive level I neck lymph nodes after dissection with only one patient suffered from marginal mandibular nerve affection and three patients complained of dry mouth post-operatively, confirming the result that there is no need for prophylactic level I neck dissection in the absence of clinically palpable suspicious lymph nodes

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