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Oral Surgery · single question

Smokeless tobacco placed habitually in the labial vestibule is MOST likely to cause initial lymph node involvement in which node group?

  1. Deep cervical lymph nodes
  2. Submandibular lymph nodes
  3. Sublingual lymph nodes
  4. Retropharyngeal lymph nodes
Show answer and explanation

Correct answer: B. Submandibular lymph nodes

  • A. Deep cervical lymph nodes are secondary drainage nodes — they receive lymph from the submandibular and submental nodes.
  • B. Correct. The labial vestibule (lip and adjacent buccal mucosa) drains primarily to the SUBMANDIBULAR lymph nodes as the first-echelon (sentinel) nodes. If malignancy develops from chronic tobacco use in this area, submandibular nodes would be first involved.
  • C. Sublingual lymph nodes drain the floor of the mouth and tip of tongue — not the labial vestibule.
  • D. Retropharyngeal nodes drain the nasopharynx and posterior nasal cavity — not the vestibule.

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