Sentinel node biopsy for melanoma in the head and neck region

Background. Lymphatic drainage in the head and neck region is known to be p articularly complex. This study explores the value of sentinel node biopsy for melanoma in the head and neck region. Methods. Thirty consecutive patients with clinically localized cutaneous me lanoma in the head and neck region were included. Sentinel node biopsy was performed with blue dye and a gamma probe after preoperative lymphoscintigr aphy. Average follow-up was 23 months (range, 1-48). Results. In 27 of 30 patients, a sentinel node was identified (90%). Only 5 3% of sentinel nodes were both blue and radioactive. A sentinel node was tu mor-positive in 8 patients. The sentinel node was false-negative in two cas es. Sensitivity of the procedure was 80% (8 of 10). Conclusions. Sentinel node biopsy in the head and neck region is a technica lly demanding procedure. Although it may help determine whether a neck diss ection is necessary in certain patients, further investigation is required before this technique can be recommended for the standard management of cut aneous head and neck melanoma. (C) 2000 John Wiley & Sons, Inc.