| Vol. 2, Issue 2, Article 2 |
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Mukherji, et al. |
II. Imaging-Based Classification(22,23)
Requisite Anatomy The Level I lymph nodes include all nodes above located below the mylohyoid muscle, above the hyoid bone and anterior to a transverse line drawn connecting posterior edge of the sub-mandibular gland. The Level I nodes are subclassified into Levels IA and IB(22, 23)
Requisite Anatomy: The Level II lymph nodes extend from the skull base, at the lower level of the bony margin of the jugular fossa, to the lower margin of the body of the hyoid bone. Level II nodes are located anterior to a transverse line connecting the posterior edge of the sternocleidomastoid muscles and posterior to a transverse line connecting the posterior edge of the submandibular glands(22, 23).
Requisite Anatomy: Level III nodes lie between the level of the lower body of the hyoid bone and the level of the lower margin of the cricoid cartilage arch and are anterior to a line connecting the posterior margins of the sternocleidomastoid muscle. These nodes are lateral to the medial margin of either the common carotid artery or the internal carotid artery(22, 23).
Requisite Anatomy: Level IV lymph nodes are located between the lower margin of the cricoid cartilage and the level of the clavicle and are lateral to the medial margin of the common carotid artery. These nodes are anterior and medial to an oblique line drawn connecting the posterior edge of the sternocleidomastoid muscle and the posterolateral edge of the anterior scalene muscle(22, 23).
Requisite Anatomy: Level V nodes are located between the skull base and the clavicle. However, unlike other Levels, these nodes are behind the sternocleidomastoid muscle and anterior to the trapezius muscle(22, 23).
Requisite Anatomy: Level VI nodes lie inferior to the lower body of the hyoid bone and superior to the top of the manubrium. These nodes are located between the medial margins of the left and right common or internal carotid arteries(22, 23).
Requisite Anatomy: The supraclavicular nodes are located at or caudal to the level of the clavicle and lateral to the carotid arteries on each side of the neck(22, 23).
Requisite Anatomy: Level VII nodes lie caudal to the top of the manubrium in the superior mediastinum, between the medial margins of the left and right common carotid arteries. These superior mediastinal nodes extend caudally to the level of the innominate vein(22, 23). |
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