OBJECTIVES: To study the efficacy of gamma-probe radiolocalization of the first draining (sentinel) lymph node ( @entity4298 ) in stage N0 @entity320 of the head and neck and to evaluate its potential role in the staging and treatment of this disease. DESIGN: Gamma-probe radiolocalization, a new alternative to blue-dye lymphatic mapping, uses a scintillation (gamma) probe to identify radiolabeled SLNs. In a consecutive sample clinical trial, gamma-probe radiolocalization of the @entity4298 is compared with lymphoscintigraphy and blue-dye lymphatic mapping. Follow-ups ranged from 1.7 years to 4 years, with a mean follow-up of 2.5 years. SETTING: Tertiary and private care teaching hospital. @entity1 : Between June 1993 and November 1995, 23 @entity1 with stage N0 intermediate-thickness @entity320 of the head and neck were enrolled in this volunteer sample. INTERVENTIONS: Twenty-four hours prior to surgery, a radioactive tracer was intradermally injected around the circumference of a primary @entity320 . Twelve @entity1 also had blue dye injected just prior to surgical resection. Using a handheld gamma probe, radiolabeled lymph nodes were identified and selectively removed with minimal dissection. In @entity1 with nodes with histologic evidence of @entity3 , a regional lymphadenectomy was performed. MAIN OUTCOME MEASURES: The successful identification of radiolabeled SLNs, the correlation of @entity4298 radiolabeling to lymphoscintigraphy and blue-dye mapping, and the long-term development of regional @entity3 . RESULTS: Surgeons successfully resected the radiolabeled SLNs in 22 (96%) of 23 @entity1 . The success rate of blue-dye lymphatic mapping was 8 (75%) of 12 @entity1 and lymphoscintigraphy was 20 (91%) of 22 @entity1 . One hundred percent of blue-stained lymph nodes were radiolabeled. The one @entity1 in whom no @entity4298 could be identified developed regional disease at 17 months. CONCLUSIONS: Gamma-probe radiolocalization and resection of the radiolabeled @entity4298 is a simple and reliable method of staging regional lymph nodes and determining the need for elective lymphadenectomy.

Localization of regional lymph nodes in XXXX of the head and neck.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity4298 :: ('6588', 'Gene') :: ['SLN']
@entity320 :: (MESH:D008545,Disease) :: ['melanomas']
