What is the anatomy of the level V group of lymph nodes in neck dissection?

Updated: Aug 19, 2020
  • Author: Ron Mitzner, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

This refers to the lymph nodes located in the posterior triangle of the neck. These include the spinal accessory, transverse cervical, and supraclavicular group of nodes. Level V is bound anteriorly by the posterior border of the sternocleidomastoid muscle and posteriorly by the anterior border of the trapezius muscle. Level V extends from the apex of the convergence of the sternocleidomastoid and trapezius muscle superiorly to the clavicle inferiorly as shown below. This level is subdivided by a plane defined by the inferior border of the cricoid cartilage into level Va superiorly and level Vb inferiorly.

Selective neck dissection for posterior scalp and Selective neck dissection for posterior scalp and upper posterolateral neck cutaneous malignancies: selective neck dissection II-V, postauricular, suboccipital, or posterolateral neck dissection.

Level Va contains the nodes associated with the spinal accessory nerve, and level Vb contains the transverse cervical and supraclavicular nodes. The posterior triangle nodes are at greatest risk for harboring metastasis from cancers that arise in the nasopharynx, oropharynx, and skin of the posterior scalp and neck.


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