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 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.