颈淋巴结清扫术课件.pptxVIP

Neck Dissection - --- 张杰 Procedure of Selective ND 3 Classfication of ND 1 Lymph Nodes Levels and Staging 2 Drainage Contents - --- Submental Submandibular Upper jugular (Anterior to XI) Upper jugular (Posterior to XI) Middle jugular Lower jugular (Clavicular) Lower jugular (Sternal) Posterior triangle (XI) Posterior triangle (Transverse cervical) Central compartment Super --- 1.Lymph Nodes Levels Sloan Kettering nomenclature(1991) Ia Ib IIa IIb III IVa IVb Va Vb VI VII - N1 Single ipsilateral lymph node, 3 cm N3 Metastases 6 cm N2 N2a: Single ipsilateral lymph node 3 to 6 cm N2b: Multiple ipsilateral lymph nodes 6 cm N2c: Bilateral or contralateral nodes 6cm Staging - --- Nasopharynx Retropharyngeal, II, III, V Oropharynx IIb IIa, III, IV, V Larygopharynx II, III,Retropharyngeal Larynx Supraglot tic IIa IIb, III, IV Subglottic VI, IV Cervical esophagus IV, VI Thyroid VI, IV, V, Mediastinal 2.Nodal Drainage - --- 3.Neck dissection Classification Neck Dissection (ND) - --- Level I-VI RND XI Radical Neck Dissection RND - --- SMG SCM IJV Removal of additional lymph node groups or non lymphatic structures Gold standard ope