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Chapter-089 Lymphoscintigraphy and Sentinel Node Biopsy

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Ruggiero Francis P
2. Dewan Anil
3. Jr Brendan Stack
ISBN
9788184486797
DOI
10.5005/jp/books/10351_89
Edition
1/e
Publishing Year
2009
Pages
12
Author Affiliations
1. Pennsylvania State University College of Medicine, Hershey, PA
2. Pennsylvania State University College of Medicine, Hershey, PA
3. Pennsylvania State University College of Medicine, Hershey, PA, USA
Chapter keywords
lymphoscintigraphy, sentinel node biopsy, sentinel lymph node, squamous cell carcinoma, metastasis, intraoperative radiolocalization, gamma probe

Abstract

This chapter discusses lymphoscintigraphy and sentinel node biopsy, where sentinel lymph node biopsy (SNB), as applied to head and neck squamous cell carcinoma, is an attempt to achieve the same staging and treatment goals as with elective neck dissection, but in a less invasive fashion. Equipment and facilities required for the successful execution of lymphoscintigraphy and SND exist in most major medical centers. A staple is fired through the skin marking made in nuclear medicine, so that it does not get erased during the skin preparation process. After preparing and draping the neck and primary site, a standard apron incision is made, and the superior and inferior flaps are elevated. Skip metastasis is the main concern that would need to be addressed before SNB could replace ELND as the principal staging procedure for patients with cN0 HNSCC. The intimate spatial relationships within the head and neck can complicate intraoperative radiolocalization using the gamma probe substantially.

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