Objectives: In this study we aimed to assess the frequencyof distribution for cervical metastases, according to the necklevel in patients with larynx cancer who underwent neck dissection.In addition, we also evaluated the safety of selectiveneck dissection compared to comprehensive neck dissectionespecially in preoperative N0 patients.Materials and methods: In our experience, to determine thefrequency of metastases in each level, the specimen is sentfor pathological examination by dividing each level separatelyafter neck dissection. In our study; we retrospectively analysedthe medical records of 145 laryngeal cancer patientswho were treated with surgery (total or partial laryngectomy)as primary treatment and combined with neck dissectionbetween 2005 and 2010 in our Otolaryngology Department.The patients with the diagnosis of laryngeal cancer who underwentsurgery without neck dissection were excluded fromthe analysis.Results: Level I or level V involvement was not observedin preoperative N0 cases. In cases that had contralateralinvolvement, there was ipsilateral involvement too and allof these cases were preoperative N+ cases. The classificationbased on the distribution of levels of 145 cases’ cervicalmetastases revealed that among ipsilateral involvements, 1(0.6%) was detected at level IA, 32 (22%) at level IIA, 3 (2%)at level IIB, 19 (13%) at level III, 2 (1.3%) at level IV and1 (1.3%) at level V. When contralateral involvement considered,13 (8.9%) were detected at level IIA and 1 (0.6%) atlevel III.Conclusions: The neck specimen findings of 145 laryngealcancer patients treated with surgery as either total or partiallaryngectomy and combined with neck dissection revealedthat the most common metastases were observed at thelevel IIA and level III; however metastases at level I, levelIIB, level IV and level V were least common. Those findingsindicated that selective neck dissection was a safe surgicalapproach (levels II-IV) in T1 T2 N0 cases. J Clin Exp Invest2012; 3 (3): 368-371Key words: Larynx cancer, cervical lymph node metastases,level