Management of the N0 Neck: Agree to Disagree? - On Demand Access

Very few topics generate as much perpetual debate on how to interrogate and surgically manage the N0 neck in the field of head and neck oncology. Over a century of clinical experience, retrospective studies and a small number of clinical trials have helped elucidate general principles for management. Yet many questions remain to be answered, particularly as OMSs attempt to move toward narrowing the gap between under treatment and over treatment. During this 60-minute webinar, participants will review the current evidence regarding surgical management, where knowledge gaps remain and the latest research efforts to fill those gaps. Preoperative imaging and tests to elucidate the clinical status of the lymph nodes will be discussed in addition the roles for observation, sentinel lymph node biopsy and elective neck dissection for the cN0 neck – all based on the latest evidence.

Learning Objectives

At the conclusion of this program, participants should be able to:

  1. Discuss evidence for elective neck dissection and gaps in evidence.  
  2. Describe sentinel node biopsy and gaps in evidence.  
  3. Explain challenges with preoperative risk stratification for occult metastasis. 
  4. Analyze ongoing research in sentinel node biopsy. 
  5. Examine ongoing research on risk stratification for occult metastasis.

An Internet-based CDE/CME Activity
Original Release Date: August 10, 2022
Expiration Date: August 10, 2025
Estimated time to complete this educational activity: 1.0 hours
Method of participation: Self-Study

Allen Cheng DDS, MD, FACS

Medical Director, Head and Neck Oncology, Legacy Cancer Institute

Head and Neck Surgical Associates, Legacy Cancer Institute

Allen Cheng DDS, MD, FACS is an alumnus of the dental and medical schools at the University of California, San Francisco. He completed his residency in oral and maxillofacial surgery at the University of California San Francisco. He is fellowship trained in both head and neck oncology and microvascular reconstructive surgery. Upon graduating from his fellowship, Dr. Cheng joined Head and Neck Surgical Associates. His practice is comprised of head and neck oncology, head and neck reconstruction, maxillofacial trauma, orthognathic surgery, and dentoalveolar surgery. He serves as Medical Director of Head and Neck Oncology at Legacy Cancer Institute and is the President-elect for the Oregon Society of Oral and Maxillofacial Surgery.

Disclosures: No Relevant Conflict of Interest Disclosures were reported.

Ashish A. Patel, DDS, MD, FACS

Fellowship Director - Head and Neck Surgery and Microsurgery

Head and Neck Surgical Associates / Providence Cancer Institute

Dr Patel is a fellowship trained Head and Neck Surgical Oncologist and Reconstructive Microsurgeon dedicated to the treatment of patients afflicted with head and neck cancers. His practices includes management and comprehensive treatment of patients with oral (mouth), pharynx (throat), larynx (voicebox), jaw, thyroid, salivary gland, skull base, and cutaneous (skin) cancers. Dr Patel's treatment philosophy hinges on comprehensive patient care with a focus on oncologic success while maintaining and restoring quality of life - giving patients back their lives is as important as eliminating cancer. He performed the first total jaw reconstruction on the West coast in 2016, and continues to push the envelope and advance the science of oncologic surgery with the use of Precision Medicine, Robotic Surgery, minimally invasive approaches and patient-specific solutions.Dr Patel is proud to be an integral part of the multidisciplinary Providence Head and Neck Cancer Program and works closely with the clinical team and scientists to offer cutting edge therapies and novel approaches to difficult problems.He is the Medical Director of the Fellowship in Head and Neck Surgery and Reconstructive Microsurgery at Providence Cancer Institute, and has the privilege of training world-class Head and Neck Surgeons. In addition, he holds academic appointments at Oregon Health and Science University and Washington State University School of Medicine and is active in Resident and Medical Student education.His primary research interests lie in early cancer detection and minimally invasive microvascular reconstruction .

Disclosures: No Relevant Conflict of Interest Disclosures were reported.

Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.0 continuing education credit(s).

AGD - Accepted Program Provider
Provider ID# 214680

The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Faculty and Planner Disclosure
3 Questions  |  1 attempt  |  0/3 points to pass
3 Questions  |  1 attempt  |  0/3 points to pass
Management of the N0 Neck: Agree to Disagree?
Open to view video.
Open to view video.
3 Questions  |  Unlimited attempts  |  2/3 points to pass
3 Questions  |  Unlimited attempts  |  2/3 points to pass
11 Questions
1.00 CDE/CME credit  |  Certificate available
1.00 CDE/CME credit  |  Certificate available