SENTINEL LYMPH-NODE MAPPING IN MELANOMA OF THE EAR

Primary nodal drainage basins in melanoma of the head and neck are oft en unpredictable. The ear is a notorious example of an anatomic site w ith ambiguous patterns of lymphatic drainage. Preoperative lymphoscint igraphy has recently emerged as one modality to assist in identifying clinically relevant nodes. We propose that the addition of intraoperat ive lymph node mapping techniques that utilize radioactive tracers ('' intraoperative lymphoscintigraphy'') can increase the accuracy of iden tifying sentinel nodes and help to determine which patients may benefi t from a complete neck dissection. This report demonstrates the ambigu ity in identifying drainage patterns in melanoma of the ear and offers a reliable method of sentinel lymph node mapping. This report also ad dresses current issues regarding treatment protocols of patients with micrometastatic disease in the periauricular region.