Lymph nodes of the head and neck: in normal and pathological conditions

Abstract

Background There are about 800 lymph nodes in the body of a healthy adult human being. Three hundred of them are in the head and neck area. The presence or absence of metastatic cancer in the head and neck lymph nodes is essential for the survival of patients. Materials and methods This article is an overview and is based on a thorough review of 25 other scientific works (24 foreign and 1 in Bulgarian)—articles, monographs, textbooks, anatomical and patho-anatomical atlases, and websites. Discussion Lymph nodes are a major part of the lymphatic system. They are small cluster formations located in strategic places in groups that play a key role in the lymphatic drainage of regional anatomical structures. The location of the lymph nodes in the head and neck region is associated with the different topographic anatomical lodges. There are different ways to group them. Topographically and anatomically, the groups of lymph nodes in the head are divided into superficial and deep. There are five types of superficial lymph nodes: facial, occipital, retroauricular, preauricular, and superficial parotid. The facial groups on their part are divided into suborbital or upper, buccal or middle, and supramandibular. Deep lymph nodes of the head include the repharyngeal and deep parotid lymph nodes. The neck lymph nodes can either be deep or superficial. Superficial lymph nodes include the submental, submandibular, and superficial lymph nodes located in front of and above the sternocleidomastoid muscle. The deep lymph nodes of the neck are classified into three groups based on their location: the upper, the middle (also called subdigastric lymph nodes), and the lower cervical third. For malignant processes in the head and neck area, nearby dissemination in the regional lymph basin (sentinel lymph nodes) is more characteristic. Depending on the initial diagnosis, the distant metastatic disease most commonly affects the lung, bones, and brain. Conclusion Knowledge of the structure, function, exact location, and lymphatic drainage of the lymph nodes of the head and neck, as well as the areas of lymphatic drainage in the same parts of the human body, is essential for making the correct diagnosis and determining the treatment plan for patients with lymphadenomegaly.

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