Sentinel node identification in laryngeal and pharyngeal carcinoma after flexible endoscopy-guided tracer injection under topical anesthesia: A feasibility study

Head Neck. 2023 Jun;45(6):1359-1366. doi: 10.1002/hed.27347. Epub 2023 Mar 21.

Abstract

Background: The aim of this study was to investigate the feasibility of flexible endoscopy-guided tracer injection for sentinel lymph node (SLN) identification in patients with laryngeal and pharyngeal carcinoma.

Methods: Sixteen cT1-4N0-2M0 patients with laryngeal or pharyngeal carcinoma underwent intra- and peritumoral [99m Tc]Tc-nanocolloid injections after topical anesthesia under endoscopic guidance. SPECT-CT scans were performed at two time points.

Results: Tracer injection and visualization of SLNs was successful in 15/16 (94%) patients. Median number of tracer injections was 1 intratumoral and 3 peritumoral. The median duration of the endoscopic procedure including tracer injection after biopsy taking was 7 min (range 4-16 min). A total of 28 SLNs were identified which were all visualized on the early and late SPECT-CT. Most SLNs were visualized in neck levels II and III.

Conclusions: Flexible endoscopy-guided tracer injection for SLN identification is a feasible and fast procedure in laryngeal and pharyngeal carcinoma patients.

Keywords: flexible endoscopy; laryngeal cancer; office-based procedures; pharyngeal cancer; sentinel lymph node.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia*
  • Carcinoma* / pathology
  • Endoscopy, Gastrointestinal
  • Feasibility Studies
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Radiopharmaceuticals
  • Sentinel Lymph Node Biopsy / methods
  • Sentinel Lymph Node* / pathology
  • Technetium Tc 99m Aggregated Albumin

Substances

  • Technetium Tc 99m Aggregated Albumin
  • Radiopharmaceuticals