Level and Pattern of Cervical Lymph Node Metastasis from Gingivo Buccal Sulcus & Palatal Mucosa of Maxilla in Oral Squamous Cell Carcinoma

Head and neck cancers (HNCs) represent a serious global health issue, it is estimated that more than 1.4 million new cases of HNC, which include cancers that originate in oral or nasal cavity, nasopharynx, oro-pharynx, hypopharynx, larynx or thyroid gland. The term ‘Oral Cancer’ is used to describe any malignancy that arises from oral tissues and accounts for the largest percentage of malignant head and neck tumours. Oral squamous cell carcinoma in maxilla is quite rare, one of the main positive prognostic factors is the abscence of metastatic cervical lymph node. This study observed the cervical level and pattern of lymph node metastasis from maxillary gingivo buccal sulcus and palatal mucosa in oral squamous cell carcinoma. Analytical cross sectional study was conducted in the Department of Oral & Maxillofacial surgery, Dhaka Dental College Hospital. Histologically confirmed squamous cell carcinoma of maxilla treated with neck dissection (Previously untreated patients) and who were tumour size T1-T4, Lymph node involvement cN0/cN+ (clinically and with sonographic examination). All the findings were included in data collection sheet which were then be analyzed and result were prepared. After collection, data editing and clearing were done manually and prepared for data entry and analysis by using SPSS (statistical package for social science) version 26. After analysis of data it was presented in the form of tables with interpretation. Out of 50 SCC patients, majority of the study patients belonged to the age group of ≥ 61 years (34%) followed by the age group 41- 50 years (30%), 51 – 60 years (30%) and ≤ 40 years (6%). The mean age ± SD: 56.02 ± 10.63 and the age range from 35 year to 80 year. Male female ratio was 1:1. Maximum (42%) of the lesions located in the gingiva buccal sulcus (GBS) followed by GBS + palatal mucosa (34%) and palatal mucosa (12%). Ultrasonographically negative lymph nodes were confirmed by histological examination where 12.90% become positive and 87.10% become negative. Oral squamous cell carcinoma of gingivobuccal sulcus, alveolar mucosa and palatal mucosa of maxilla needs prophylactic neck dissection in case of N0 neck. Most of the cases of anterior maxilla metastasis to jugulodigastric lymph nodes. Ultrasonograph of neck is not only non-invasive investigation, but also needs MRI for proper evaluation.