Deep cervical fascia as an anatomical landmark of lingual lymph nodes: An anatomic and histologic study

Metastasis to the lateral lingual lymph node located behind the submandibular gland: A case of squamous cell carcinoma of the tongue

“…8,9 When conservative ND is performed, the deep portion of the SLDCF is preserved, covering XII beneath. 9,10 The findings of this case correspond to the described theory (Figure 3). Previous descriptions of LLNs, such as those by Rouvière 1 and DiNardo, 11 did not refer to the fascial anatomy; this may explain the confusion between LLNs located behind the SMG and level IB nodes in previous studies.…”

“…The SMS forms a bag shape with the SLDCF, and the posterior medial wall of the SMS is composed of the deep portion of the SLDCF 8,9 . When conservative ND is performed, the deep portion of the SLDCF is preserved, covering XII beneath 9,10 . The findings of this case correspond to the described theory (Figure 3).…”

“…Researchers have had different opinions regarding LLNs 12 . Based on the anatomical evidence 8‐10 and clinical experience, we present an idea of classifying LLNs into four groups, namely median, anterior lateral, posterior lateral, and parahyoid LLNs (Figure 1A,B,C,D). Increasing evidence of LLN metastasis has been presented in recent years 13,14 ; incidence reported to be 1.3%‐17.1% 12 .…”

Lingual lymph nodes: Anatomy, clinical considerations, and oncological significance

“…The precise affiliation of this node is debatable, since it topographically belongs to the submandibular space, which is outside the sublingual and floor of the mouth regions. On the other hand, relevant anatomical material was recently published by Eguchi et al[ 17 ]. During gross dissection, the authors managed to identify a thin fascial lamina located deep to the submandibular salivary gland that covered the hyoglossus muscle and the lingual and hypoglossal nerves.…”

“…The authors assumed that the posterolateral LLN or deep submandibular node is also covered by that facial layer, which in turn extends to the sublingual region. These nodes therefore may be anatomically related to the LLN group[ 17 ]. Further micro- and macroscopic research of the floor of the mouth and submandibular triangle anatomy is needed to clarify this controversial issue.…”