A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck

Background. Debate continues over the management of the NO neck in head and neck malignancy. Therefore, the possibility of performing sentinel node bi opsy in these patients was investigated to formulate a method for the proce dure. Methods. Patients undergoing prophylactic or therapeutic neck dissections w ere injected with either Patent Blue V dye alone or with blue dye and 99m-T c labeled Albures. The latter group underwent preoperative lymphoscintigrap hy. During surgery, blue stained lymphatics were followed to blue nodes, an d a neoprobe was used to identify radioactive nodes. Results. In 5 of 13 patients receiving blue dye,a blue node was identified, but none contained tumor. Metastases were identified in other neck nodes i n 3 of 5. Sentinel nodes were identified in 15 of 16 patients receiving dye , and Albures. Sentinel node biopsy was accurate in 7 of 7 necks containing impalpable metastases when all nodes had been evaluated after dissection. Discussion. Sentinel node biopsy using blue dye and radiocolloid may prove to be a reliable technique in the NO neck and warrants further investigatio n. (C) 1999 John Wiley & Sons, Inc. Head Neck 21: 728-733, 1999.