Supraomohyoid neck dissection in the ultrasonographically and clinically No neck in oral carcinoma

Introduction. The objective was determination of the value of supraomohyoid neck dissection in clinically and sonographically node-negative squamous cell carcinoma of the oral cavity. Methods. A retrospective analysis of the results of this operation between 1992 and 1996 was undertaken. Results. During this period, 116 supraomohyoid neck dissections were performed in 101 patients. Occult metastases were found in 25 (21.6%) neck dissections. Twelve were identified peroperatively with frozen section analysis and were converted to a modified radical neck dissection. Fourteen received postoperative radiotherapy. Six patients had no additional treatment. Median follow-up was 41 months. A locoregional recurrence was seen in three patients (3.6%) and a regional recurrence in five (4.3%). Of these seven patients, five died of disease. Five year actuarial survival was 89%. Conclusion. Occult metastatic disease in oral carcinoma has been reduced from 35%1 to 21.6% with routine ultrasonography of the neck. Awaiting further refinement of the diagnostic imaging of the neck, elective supraomohyoid neck dissection still seems to be a first-choice treatment in these patients.