Davies-Husband CR, et al. - In the present study, the researchers sought to provide an updated, systematic and comprehensive summary of the literature pertaining to the management of the N0 neck in patients for whom primary irradiation for squamous cell carcinoma of the larynx has been unsuccessful and salvage surgery advocated. They conclude that the collated studies during salvage laryngectomy are not of sufficient homogeneity or quality to make generalised recommendations concerning END for the N0 neck, irrespective of patterns found by amalgamation. While the occurrence of occult metastases in patients with more locally advanced supraglottic tumors and those patients with N+ prior to initial radiation therapy tends to be higher, this finding should be viewed with caution. The association between regional recurrence and DSS is not linear and therefore has the potential to expose a significant proportion of patients to an increased risk of surgical complications through END, with no significant survival benefit. Finally, patients should be fully involved in the decision-making process and their performance status and comorbidities should be carefully taken into account when deciding to increase the extent of surgery which they conclude through this narrative will, in most cases, remain limited to TL alone.