Selective Neck Dissection in the Management of the Clinically Node‐Negative Neck

<jats:title>Abstract</jats:title><jats:p><jats:bold>Objective</jats:bold> To evaluate the efficacy of the selective neck dissection (SND) in the management of the clinically node‐negative neck.</jats:p><jats:p><jats:bold>Study Design</jats:bold> Case histories were evaluated retrospectively.</jats:p><jats:p><jats:bold>Methods</jats:bold> The results of 300 neck dissections performed on 210 patients were studied.</jats:p><jats:p><jats:bold>Results</jats:bold> The primary sites were oral cavity (91), oropharyn‐ (30), hypopharyn‐ (16), and laryn‐ (73). Seventy‐one necks (23%) were node positive on pathological e‐amination. The number of positive nodes varied from 1 to 9 per side. Of necks with positive nodes, 17 (24%) had e‐tracapsular spread. The median follow‐up was 41 months. Recurrent disease developed in the dissected neck of 11 patients (4%). Two recurrences developed outside the dissected field. The incidence of regional recurrences was similar in patients in whom nodes were negative on histological e‐amination (3%) when compared with patients with positive nodes without e‐tracapsular spread (4%). In contrast, regional recurrence developed in 18% of necks with e‐tracapsular spread. This observation was statistically significant. Patients having more than two metastatic lymph nodes had a higher incidence of recurrent disease than the patients with carcinoma limited to one or two nodes. Recurrence rate in the pathologically node positive (pN+) necks was comparable to recurrence in those pathologically node negative (pN0) necks in the patients who did not have irradiation.</jats:p><jats:p><jats:bold>Conclusion</jats:bold> SND is effective for controlling neck disease and serves to detect patients who require adjuvant therapy.</jats:p>