RESUMO
Neck node metastasis is the most important prognostic factor in the management of head and neck cancer. Therefore, the early ability to identify the risk of metastasis and its appropriate treatment is crucial to obtaining a cure in these patients. To evaluate selective neck dissection as a treatment option in the management of NO neck in cases of cancer larynx using histopathology and immunohistochemistry. Twenty four patients had laryngeal tumours were staged as clinically NO according to clinical and radiological [CT scan] examination were included in this work. Selective neck dissection was the performed procedure for management of their necks [lateral neck dissection levels II -lv]. Thirty three lateral neck dissections were performed in 24 cases as bilateral neck dissection was done in 9 cases. Lymph nodes were assessed intraoperatively to whether negative for metastasis, positive or suspected. Histopathologically, the specimens examined first with serial sectioning in 5-to 6- micron interval with hematoxylin and eosin [H and E] staining, then inmunostaining for cytokeratins using the monoclonal antibody cocktail AE1/AE3 was done for the negative specimens. Suspected lymph nodes were recorded intraoperatively in seven out of 33 dissections [21.2%]. Using the ordinary hematoxylin and eosin staining, lymph nodes were positive in 11 specimens [33.3%] and negative in 22 specimens [66.7%] with false positive rate [14.3%] and false negative rate [19.2%], Cytokeratin immunohistochemical analysis increases the affected specimens to 13 sepcimens [39.4%] with the same false positive rate [14.3%] and increased false negative rate to [26.9%]. Selective neck dissection [SND] is a valuable treatment option in all cases of NO neck in laryngeal carcinoma when open surgery is selected for the treatment of the primary tumour. SND allows removal of subclinical and subpathological metastases and thus allows accurate staging and treatment of occult disease and assists in patient counseling and prognosis