2014 Volume 40 Issue 4 Pages 453-458
We retrospectively evaluated methods of neck dissection in patients with previously untreated parotid carcinoma who received definitive surgery. The subjects were 42 patients treated in our department from 1987 through 2011. All 10 patients with clinical neck lymph node metastasis underwent ipsilateral neck dissection and 6 developed neck lymph node recurrence, 2 of which recurred in the non-dissection field. Of 32 patients without clinical neck lymph node metastasis, 23 did not undergo prophylactic neck dissection among which latent neck lymph node metastasis developed in only 1 case. Pathological positive lymph nodes in 11 patients who underwent neck dissection were detected all over (level I to V) the ipsilateral neck and the recurrent positive rate at level II was 100%. We conclude that in cases with clinical neck lymph node metastasis, ipsilateral radical neck dissection is appropriate, and in cases without clinical neck lymph node metastasis, prophylactic neck dissection is not usually needed. We suggest that it is useful to perform pathological examinations using frozen sections from intraoperative level II nodes to decide whether prophylactic neck dissection should have been carried out.
