Objective To evaluate the missing diagnosis of neck metastases by routine detecting method （palpation combined with one pathological slide） in laryngeal carcinomas.Methods Sixty-six specimens of neck dissections were collected and observed by routine method

transparent method

and continuous sliding method.Results Totally

1153 lymph nodes were detected by palpation method and another 1204 lymph nodes were detected by transparent method.The lymph nodes detected by transparent method account for 51.1% of the total

and among them 10 metastases were found

which account for 15.6%（10/64） of metastatic lymph nodes.For those with no metastasis detected by routine method

50 μm interval continuous sliding method was performed

and 14 tiny metastases were found

which account for 21.9%（14/64） of metastatic lymph nodes.Detecting by routine method

most lymph nodes （95%） were in tumor growth and tumor suffusion stage.The missing diagnosis rate of routine method was 37.5%（24/64）.Conclusions When routine method was used to detect lymph nodes in neck specimens

missing diagnosis should be considered to select best therapy.Through transparent method small lymph nodes could be found and it is a valuable method to observe pathological changes of small nodes.Continuous sliding method could find micrometastasis precisely

but the work burden is heavy and it is difficult to be widely used.