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

Abstract

Purpose:Metastatic involvement of the lingual lymph nodes (LLNs) in oral cavity squamous cell cancer has recently been proven to signi cantly reduce locoregional control and survival. Despite recent re nements 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 de ned: median -between genioglossal and geniohyoid muscles; intermediate para-hyoid -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 uni ed anatomical topographic classi cation of LLN subgroups may be among the important conditions for improving the detection and treatment of LLN lesions.