Role of selective sentinel lymph node dissection in head and neck melanoma
Article first published online: 19 AUG 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Special Issue: Seminars in Surgical Oncology: Melanoma
Volume 104, Issue 4, pages 361–368, 15 September 2011
How to Cite
Leong, S. P.L. (2011), Role of selective sentinel lymph node dissection in head and neck melanoma. J. Surg. Oncol., 104: 361–368. doi: 10.1002/jso.21964
- Issue published online: 17 AUG 2011
- Article first published online: 19 AUG 2011
- Manuscript Accepted: 8 APR 2011
- Manuscript Received: 10 JAN 2011
- head and neck;
- lymph node
Selective sentinel lymph node dissection (SLND) plays an important role in the staging of the regional nodal basins for head and neck (H&N) melanoma. Preoperative lymphoscintigraphy is mandatory to identify the regional nodal basin(s) accurately for a newly diagnosed H&N primary melanoma of at least 1 mm or greater. A wide local excision should be delayed if SLN mapping is indicated, to minimize watershed effect and maximize accuracy in identifying the “true” SLN because of the complex lymphatic network in the H&N region. An experienced multidisciplinary team is required for optimal identification of H&N SLNs. In general, selective SLND can replace ELND to minimize the complications of a neck dissection. Completion lymph node dissection is only indicated when the SLN is positive. A nerve stimulator should be used during selective SLND in the parotid and posterior triangle to minimize the injury to the facial and spinal accessory nerve. J. Surg. Oncol. 2011; 104:361–368. © 2011 Wiley-Liss, Inc.