Surgical anatomy of the lingual lymph nodes: systematic literature analysis and proposition for topographic classification.

PURPOSE: Metastatic involvement of the lingual lymph nodes (LLNs) in oral cavity squamous cell cancer (SCC) has recently been proven to significantly reduce locoregional control and survival. Despite recent refinements in the detection of these lesions, the understanding of the LLN topographic anatomy among clinicians is limited. A proposition of a topographic division on LLN based on a comprehensive literature search and synthesis may be helpful in this condition. METHODS: A literature search and election based on contemporary PRISMA guidelines was performed for sources on LLN anatomy with special attention on their subdivision. RESULTS: Four topographic LLN subgroups were defined: median-between genioglossal and geniohyoid muscles; intermediate parahyoid-medial to the hyoglossal muscle, at the greater cornu of the hyoid bone; lateral sublingual (paraglandular) LLNs-at the sublingual salivary gland; lateral submandibular (paraglandular) LLNs -lateral to the hyoglossal muscle, at the deep surface of the submandibular salivary gland. CONCLUSION: The development and implementation of a unified anatomical topographic classification of LLN subgroups may be among the important conditions for improving the detection and treatment of LLN lesions.

Clinical and Demographic Characteristics of Tearing in Patients after Radioiodine Ablation for Differentiated Thyroid Cancer.

Background: Radioiodine ablation is a frequent procedure for the management of thyroid cancer. In several cases, this treatment is followed by secondary acquired nasolacrimal duct obstruction (SALDO). Risk factors for the development of SALDO are not defined yet.Aim - to provide clinical and demographic characteristics of tearing in patients after radioiodine treatment.Materials and methods: Material was obtained by a phone survey of 588 patients who underwent radioiodine treatment. Age and gender of the respondent, strength of administered medication, and time since the end of treatment were taken into account. Patients were asked if they had dry mouth and/or tearing at the time of the survey. Differences in values were found using parametric and nonparametric criteria, Pearson's χ2 test. Differences were considered statistically significant at p ≤ 0.05.Results: Severe tearing was reported by 8.8% of patients after single-dose radioiodine treatment and 23.9% of patients after repeated one. The age of patients with severe tearing and without it showed statistically significant difference in patients after single-dose radioiodine treatment and no statistically significant difference in patients after repeated radioiodine treatment. Administration of 4 GBq or more in patients aged 61-71 years results in 4-fold increase of the risk of severe tearing. Dry mouth causes 3.6-fold increase of the risk of developing severe tearing.Conclusion: Finding risk factors for SALDO development after radioiodine therapy in the future will contribute to an individualized approach to the prevention of this complication. Development of preventive measures is one of the tasks facing researchers.