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Surgical anatomy of the lymphatic drainage of the salivary glands: a systematic review

Abstract Background Nodal metastasis in salivary gland malignancies has important clinical implications; a good understanding of their complex anatomy is paramount to the head and neck surgeon. Methods A contemporary and comprehensive literature review was conducted of the lymphatic drainage of the salivary glands, with special emphasis on its surgical applications. Results The parotid gland has extraglandular and intraglandular nodes acting as a single functional drainage unit. Intraglandular parotid notes are unique to the parotid gland, and consist of a larger superficial group and a smaller deep group. The presence of intraglandular submandibular nodes, as described by early anatomists, is much debated nowadays. The sublingual glands drain to the lingual lymph nodes, which are divided into median, intermediate and lateral groups. Conclusion This review highlights the complex arrangements of lymph nodes draining the salivary glands. It may provide a valid anatomical explanation for the nodal metastasis patterns commonly seen in salivary gland malignancy.