An exploration of the surgical modality of sentinel lymph node biopsy in patients with cN0 tongue carcinoma: an animal study.

OBJECTIVE: Lymphatic mapping with vital dye is often exploited during a sentinel lymph node biopsy (SLNB); however, the time restraints associated with blue dye may limit its efficacy in tongue carcinoma. Using an animal study, this exploration attempted to achieve a rational surgical modality to circumvent this hindrance. STUDY DESIGN: Forty-eight rabbits were divided into 2 equal groups: A and B; 0.2 mL methylene blue (MB) was injected into 4 parts of the tongues of the rabbits in A just after elevating the cervical flap and into the tongues of the rabbits in B just before the elevation. The times when the lymphatic vessel and lymph node turned blue and then returned pale were recorded. RESULTS: Cases in group A had significantly more time left for tracing blue-stained lymphatic vessels than those in group B. CONCLUSIONS: Elevating the cervical flap before injecting MB can alleviate the time restraint of MB as a lymphatic tracer in SLNB with tongue carcinoma.

Site-specific lymphatic mapping relative to lingual septum in localizing the regional lymph nodes of tongue - an animal study.

BACKGROUND AND OBJECTIVES: With technical adaptations, recent studies showed SLNB could predict cervical nodes status of head and neck carcinoma with high accuracy. However, as for tongue carcinoma, such technical adaptations seem to be not enough because the tongue has peculiar characteristic which may demand a specific procedure for accurate lymphatic mapping. This investigation explored the effect of lingual septum on lymphatic mapping of tongue to provide data for achieving an accurate lymphatic mapping for managing early tongue carcinoma. METHODS: Four doses of Methylene Blue were injected into various parts of 64 rabbits' tongue, then diffusion range of Methylene Blue in tongue and sites of cervical nodes stained blue were noted. Finally, the tongues were resected for further histological examination and morphometric assessments. RESULTS: There was lingual septum in the tongue and the diffusing of Methylene Blue could be terminated by lingual septum. Blue-stained nodes were identified in 84 lateral necks of 60 rabbits. CONCLUSIONS: A site-specific way of lymphatic mapping relative to lingual septum should be developed for staging early tongue carcinoma.