Head and Neck Surgery — MCQs

Q: A patient with a malignant lesion involving the posterior one -third of the tongue is being evaluated for regional lymph node metastasis. Which lymph nodes are most commonly involved in the lymphatic drainage of this region?

Deep cervical lymphnodes. ***Deep cervical lymph nodes*** - The posterior one-third of the tongue, specifically the **base of the tongue** (posterior to the circumvallate papillae), drains directly into the **deep cervical lymph nodes**, particularly the **jugulodigastric nodes**. - Because the drainage is bilateral and extensive, malignant lesions in this region often metastasize early to these deep nodes. *Submental lymph nodes* - These nodes primarily drain the **tip of the tongue**, the **floor of the mouth**, and the **lower incisors**. - They are not involved in the primary lymphatic drainage pathway of the posterior third of the tongue. *Submandibular lymph nodes* - These nodes receive lymphatic drainage from the **lateral parts of the anterior two-thirds of the tongue**, as well as the submandibular and sublingual glands. - They are considered a sentinel station for tumors of the floor of the mouth and the anterior oral cavity, not the posterior base. *Periauricular lymph nodes* - These nodes are located around the ear and primarily drain the **scalp**, **eyelids**, and the **external auditory canal**. - They are clinically irrelevant to the lymphatic drainage patterns of the tongue musculature and specialized mucosa.

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