Is Elective Contralateral Neck Dissection Necessary in 53 Salvage Total Laryngectomy Patients

Contralateral neck dissection in the salvage laryngectomy setting is controversial and associated with significant morbidity. 13% had pathologically proven disease (cN0Pn+) during salvage laryngectomy, despite no clinical or radiological evidence of neck disease. 92% had lateralised disease and 74% had a prophylactic contralateral neck dissection. 2% had occult pathological disease in the contralateral neck histology. The rate of occult contralateral nodal disease is low in lateralised primary disease and contralateral neck dissection can be safely spared in selected patients.