Department of Otolaryngology - Head and Neck Surgery, Sidney Kimmel Cancer Center at Abington, Jefferson Health, Willow Grove, Pennsylvania, USA.
Department of Otolaryngology - Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
Head Neck. 2024 Jan;46(1):212-217. doi: 10.1002/hed.27563. Epub 2023 Nov 7.
We depict an innovative surgical approach for sentinel lymph node biopsy (SLNB) in head and neck malignancies that utilizes both near-infrared (NIR) imaging with indocyanine green (ICG) dye and hand-held gamma probe intraoperatively to isolate and excise SLNs. Twenty-one patients presented to our institution with cutaneous melanoma, cutaneous squamous cell carcinoma (SCC), and oral cavity SCC tumors that met criteria for SLNB based on tumor depth and histology. The video offers a step-by-step approach for this technique along with descriptions of recommended equipment. Among 21 patients, two patients had positive SLNs on final pathology. One patient developed a local recurrence over an average of 16.2 months of follow-up (SD = 15.6). SLNB with ICG and radionucleotide co-localization may enhance the identification of sentinel nodes without compromising outcomes in the hands of surgeons well-versed in the technique.
我们描述了一种用于头颈部恶性肿瘤前哨淋巴结活检（SLNB）的创新手术方法，该方法结合近红外（NIR）成像和吲哚菁绿（ICG）染料以及术中手持式伽马探针来分离和切除 SLN。21 名患者因皮肤黑色素瘤、皮肤鳞状细胞癌（SCC）和口腔 SCC 肿瘤就诊，根据肿瘤深度和组织学符合 SLNB 的标准。该视频提供了该技术的分步方法，并介绍了推荐的设备。在 21 名患者中，有 2 名患者的 SLN 在最终病理检查中呈阳性。1 名患者在平均 16.2 个月（SD=15.6）的随访中出现局部复发。ICG 和放射性核素共定位的 SLNB 可以增强对前哨淋巴结的识别，而不会在手术医生熟练掌握该技术的情况下影响结果。
