[4] Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.

[8] However, this system was based upon anatomical landmarks found in dissection, making it imperfectly suited to the needs of clinicians, which led to new terminology for the lymph nodes that could be palpated.

The most commonly used system is one based on a classification of the lymph nodes into numbered groupings, devised at the Memorial Sloan Kettering Cancer Center in the 1930s.

In 1991, the American Academy of Otolaryngology published a standardised version of this[9]to provide a uniform approach to neck dissection that was updated in 2002, including the addition of sub-levels, e.g. IIA and IIB.

Involvement of the cervical lymph nodes with metastatic cancer is the single most important prognostic factor in head and neck squamous cell carcinoma and may be associated with a halving of survival.