Involvement of level I neck lymph nodes and submandibular gland in laryngeal and/or hypopharyngeal squamous cell carcinoma

Objective: To investigate the prevalence of level 1 neck lymph node metastases or submandibular nodal metastases in laryngeal and/or hypopharyngeal squmous cell carcinoma (SCC). Patients and Methods: One hundred fifty consecutive neck dissection specimens from 100 patients with laryngeal and hypopharyngeal SCC, who were treated at our institution between 1992 and 2002, were retrospectively reviewed. Results: The tumour stage was T1-T4, and the neck stage was N0-N3. Metastases were never found in level 1 (la + lb) or in the submandibular gland. Metastases were concentrated within the jugular chain (levels II-IV in 92.2% of the N-positive necks). Conclusion: Metastases of level 1 of the neck and the submandibular gland are extremely rare in cases of laryngeal and/or hypopharyngeal carcinoma. The risk of facial or hypoglossal nerve injury does not justify the dissection of level I and of the submandibular gland in this type of tumour.