Lymph node levels of the neck

Lymph node levels of the neck

Lymph nodes in the neck have been divided into 7 levels, generally for the purpose of squamous cell carcinoma staging. This is however not all inclusive as the parotid nodes and retropharyngeal space nodes are not included in this system.

Level I : below myohyoid to hyoid bone anteriorly
Level Ia : submental
Level Ib : submandibular
Level II : jugulodigastric (base of skull to hyoid)
Level III : deep cervical (hyoid to cricoid)
Level IV : Virchow (cricoid to clavicle)
Level Va : accessory spinal (posterior triangle) : superior half
Level Vb : accessory spinal (posterior triangle) : inferior half
Level VI : prelaryngeal / pretracheal / Delphian node
Level VII : superior mediastinal (between CCAs, below top of manubrium)