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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Bachter D., Michl C., Büchels H. *, Balda B.-R., Morley A. ***, Vogt H. **
From the Departments of Dermatology and Allergology * Plastic Surgery, and ** Nuclear Medicine Augsburg (Germany)
*** Department of Ear, Nose and Throat Brighton (Great Britain)
Background. The removal of the sentinel lymph node (SLN), defined as the first tumor-draining lymph node within the nearest lymph node region, is well established in the primary therapy of malignant melanoma. While the gamma-probe guided sentinel lymphonodectomy (g-SLNE) is regarded as unproblematic for tumors located on the trunk and extremities, many surgeons hesitate to apply this method to melanoma of the head and neck region, firstly because of difficulties of the preoperative identification of the SLN by lymphoscintgraphy, secondly because of the complex anatomy of this area.
Methods. We performed g-SLNE after dynamic lymphoscintigraphy in 41 patients suffering from malignant melanoma of the head and neck region. The preoperative identification of the SLN failed only in two cases, where extensive tumors were directly overlying the draining basin, the intraoperative localization succeeded in all patients.
Results. Significant intra-and postoperative complications were not observed. During a 6-year follow-up period no patient developed lymph node recurrences.
Conclusions. The purpose of this report is therefore not only to describe clinical experiences with g-SLNE in patients suffering from cutaneous malignant melanoma of the head and neck region but also to show that it is really a reliable minimally invasive surgical procedure, dealing with the pre- and intraoperative considerations.