LYMPHATIC MAPPING WITH ISOSULFAN BLUE-DYE IN SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK

Objective: To determine whether intraoperative lymphatic mapping with isosulfan blue dye and sentinel lymph node biopsy accurately demonstra tes the pathway of regional metastases from mucosal. sites in squamous cell carcinoma of the head and neck. Design: A prospective clinical s tudy of intraoperative lymphatic mapping. Setting: An academic tertiar y referral center. Patients: Patients with previously untreated squamo us cell carcinoma of the head and neck whose surgical treatment includ ed neck dissection. Intervention: Injection of isosulfan blue dye into the mucosa surrounding squamous cell carcinomas of the upper aerodige stive tract during cervical lymphadenectomy. Outcome Measures: Correla tion of the pathologic findings in the blue sentinel lymph node with t hose in the remaining cervical lymphatics. Results: No blue-stained ce rvical lymphatics were identified after injection of the mucosa surrou nding the primary squamous cell carcinoma with isosulfan dye. Conclusi on: The technique of intraoperative lymphatic mapping with isosulfan b lue dye requires further study before it can be used for the detection of occult cervical metastases in squamous cell carcinoma of the head and neck.