Results and analysis
There were 61 patients included who underwent 63 NDs, of which 49 had a primary tonsillar tumours, 9 had primary tongue base tumours and 3 had unidentified primary tumours. Demographics, smoking history, clinical staging method and surgical details are shown in Table 1. A mean of 37.9 nodes were excised during each ND (SD 20.7) with cN0 necks yielding more nodes (mean 48.1) compared to cN+ve necks (mean 36.2, p = 0.09), likely due to small sample sizes from cN0 necks. The mean number of positive nodes per ND was 3.3 (median 2, range 1-19).
Overall, one patient was downstaged on pathological nodal staging (from cN1 to pN0). Eleven of the sixty-one patients were upstaged, (seven from cN1 to pN2 and four from cN0 to pN1). Staging for the remaining forty-nine patients was unchanged.