Lymphatics of Head and Neck

• Lymph vessels from the face, scalp, and ear drain into the occipital, retroauricular, parotid, buccal (facial), submandibular, submental, and superficial cervical nodes, which in turn drain into the deep cervical nodes (including the jugulodigastric and jugulo-omohyoid nodes).

• The middle ear drains into the retropharyngeal and upper deep cervical nodes; the nasal cavity and paranasal sinuses drain into the submandibular, retropharyngeal, and upper deep cervical; the tongue drains into the submental, submandibular, and upper and lower cervical; the larynx drains into the upper and lower deep cervical; the pharynx drains into the retropharyngeal and upper and lower deep cervical; and the thyroid gland drains into the lower deep cervical, prelaryngeal, pretracheal, and paratracheal nodes.

• Lie along the external jugular vein in the posterior triangle and along the anterior jugular vein in the anterior triangle.
• Drain into the deep cervical nodes.

1) Superior deep cervical nodes

• Lie along the internal jugular vein in the carotid triangle of the neck.
• Receive afferent lymphatics from the back of the head and neck, tongue, palate, nasal cavity, larynx, pharynx, trachea, thyroid gland, and esophagus.
• Have efferent vessels that join those of the inferior deep cervical nodes to form the jugular trunk, which empties into the thoracic duct on the left and into the junction of the internal jugular and subclavian veins on the right.

2) Inferior deep cervical nodes

• Lie on the internal jugular vein near the subclavian vein.
• Receive afferent lymphatics from the anterior jugular, transverse cervical, and apical axillary nodes.