Retropharygneal node dissection

Abstract

Metastasis to the retropharyngeal lymph nodes is not common for malignancies of the upper aerodigestive tract, salivary glands or thyroid. However, retropharyngeal metastasis is not a rare occurrence either and lymph node dissection may be required for therapeutic purposes. Prompt identification and management is paramount for disease control. Evidence of nodal involvement is the main indication for surgical dissection if radiotherapy is not available or effective. Significant extranodal extension with carotid or prevertebral involvement are considered contraindications to dissection. Surgical approach selection is vital as access can be limited. Both transcervical and transoral routes are available for appropriately experienced surgeons. Each approach has its advantages and disadvantages in set up, safety, and postoperative complications. These factors, along with need for concurrent tumor treatment should be considered when dissecting these lymph nodes.