Effectiveness of the supraomohyoid neck dissection in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus

BACKGROUND: To evaluate the effectiveness of the supraomohyoid neck dissection in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus. MATERIALS AND METHODS: This was a prospective study of five patients with squamous cell carcinoma of gingivobuccal mucosa of oral cavity with clinically N0 neck, conducted over a period of 2 years from July 2007 to Oct 2009 in the Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital. The study was conducted in patients irrespective of age, sex, size, thickness, and type of differentiation of the lesion. All patients have clinically non-palpable lymphnodes (N0 neck), while patients with palpable lymphnodes, patients with previous surgery, and patients with previous radiotherapy were excluded from the study. RESULTS: Level I was the commonest site of neck metastasis in our study. Among the five patients, two (40%) patients (case 2 and 3) had occult cervical metastasis (level IB nodes are histopathologically positive nodes) and the remaining three patients (60%) had no occult cervical metastasis. The recurrence rate was 20% for patients who received postoperative radiotherapy. There was no morbidity and postoperative dysfunction and the mortality rate was only 20% in our study. CONCLUSION: Supraomohyoid neck dissection is the therapeutic procedure in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus of mandible. Supraomohyoid neck dissection, when indicated, contributes to the concept of less-invasive surgery and offers functional and aesthetic advantages without compromising the clearance with minimal morbidity.