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Karen T. Pitman, MD; Jonas T. Johnson, MD; Howard Edington, MD; E. Leon Barnes, MD; Roger Day, ScD; Robin L. Wagner; Eugene N. Myers, MD

Arch Otolaryngol Head Neck Surg. 1998;124:790-793.

Objective  To determine whether intraoperative lymphatic mapping with isosulfan blue dye and sentinel lymph node biopsy accurately demonstrates the pathway of regional metastases from mucosal sites in squamous cell carcinoma of the head and neck.

Design  A prospective clinical study of intraoperative lymphatic mapping.

Setting  An academic tertiary referral center.

Patients  Patients with previously untreated squamous cell carcinoma of the head and neck whose surgical treatment included neck dissection.

Intervention  Injection of isosulfan blue dye into the mucosa surrounding squamous cell carcinomas of the upper aerodigestive tract during cervical lymphadenectomy.

Outcome Measures  Correlation of the pathologic findings in the blue sentinel lymph node with those in the remaining cervical lymphatics.

Results  No blue-stained cervical lymphatics were identified after injection of the mucosa surrounding the primary squamous cell carcinoma with isosulfan dye.

Conclusion  The technique of intraoperative lymphatic mapping with isosulfan blue 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.

From the Departments of Otolaryngology (Drs Pitman, Johnson, and Myers and Ms Wagner), Plastic Surgery (Dr Edington), and Pathology (Dr Barnes), University of Pittsburgh School of Medicine, and the Department of Biostatistics, University of Pittsburgh Cancer Institute (Dr Day), Pittsburgh, Pa. Dr Pitman is now with the Department of Otolaryngology, Naval Medical Center, Portsmouth, Va.

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