Lingual lymph nodes: Anatomy, clinical considerations, and oncological significance

Table 2 Clinical series related to lingual lymph nodes

Year	Ref.	Clinical data	Recommendations
1994	Omura et al[36]	Reported 1 case of median LLN and 3 cases of lateral LLN among 311 patients (1.3%) with tongue SCC	Mandatory intraoperative palpation in the areas of potential LLNs location
2009	Ando et al[35]	Observed parahyoid nodes involvement in 6.3% of 248 patients with T1-2 oral tongue SCC	Intraoperative inspection of tissue along the course of lingual artery for possible firm LLN during ND
2010	Hoshina et al[16]	Positive in-transit LLNs visualized and proven metastatic in 16.3% of their 43 patients	Routine preoperative imaging and careful data interpretation for possible occult in-transit LLN metastasis
2011	Calabrese et al[38]	Designed a modification of in-continuous resection. 143 patients with previously untreated tongue SCC. In 5 years, loco-regional control was 83.5% (24.4% improvement on standard surgery); overall survival of 70.7% (27.3% improvement)	Advocated en-bloc resection of a hemi-tongue compartment that includes the underlying mouth floor tissues, the stylohyoid and mylohyoid muscles
2016	Suzuki et al[14]	Reported incidence of 8% of LLNs metastasis in a series of 100 tongue SCC	Proposed recommendations for choosing surgical access to different groups of LLNs
2017	Tomblinson et al[13]	500 consecutive face-neck MRI-scans were reviewed for structures consistent with median LLNs	In the study group, 1 (0.95%) of 105 cases demonstrated a single median LLN metastasis from a lateral tongue tumor
2018	Jia et al[46]	Reported total incidence of LLN metastasis of 17.1% in 111 patients with T0-4, N0, N+ tongue cancer	The existence of LLN metastasis was found to significantly associate with the pathological grade of the tumor
2019	Fang et al[47]	Treated 231 patients with T2-4, N0, N+ tongue SCC, all underwent an in-continuity operation. The surgical specimen of the floor of the mouth was separated postoperatively and histologically studied for the presence of LLNs and LLNs metastasis	It was shown that LLN metastasis were significantly related with the following pathologic features: the lymphovascular and peritumoral invasion, tumor stage, regional metastasis and malignancy grade

LLNs: Lingual lymph nodes; SCC: Squamous cell carcinoma; ND: Neck dissection; RND: Radical neck dissection; MRND: Modified radical neck dissection; FND: Functional neck dissection.