The role of suprahyoid neck dissection in the management of cancer of the tongue and floor of the mouth

Suprahyoid lymph node dissection often is used as part of the surgical treatment of cancers of the anterior two thirds of the tongue and the floor of the mouth. In recent years the use of this procedure has become less widespread, but it is still advocated by some surgeons as a sound operation in the treatment of cancer. Anatomic, roentgenographic, and pathologic evidence is presented to show that this may not be the case. The evidence points out that such neoplasms do not metastasize in an orderly or predictable pattern. These patients may have isolated metastases in any region of the neck. If the decision is made to treat the neck in these situations, the whole neck should be treated. We feel that suprahyoid neck dissection has a very limited role to play in the management of cancers of the anterior two thirds of the tongue and the floor of the mouth and should be employed only when it will be of help in developing an adequate margin around the primary lesion.