title: Imaging of eyelid lymphatic drainage.
abstract: OBJECTIVE
  Traditional descriptions of lymphatic drainage show eyelids emptying into the submandibular or preauricular basin. However recent studies based on in vivo lymphatic imaging show a possible predilection for the preauricular basin. We describe lymphoscintigraphy and report findings in patients with eyelid malignancies undergoing sentinel lymph node biopsy (SLNB).
  
  
  METHODS
  Retrospective chart review of 15 consecutive patients at a single institution with eyelid carcinoma undergoing SLNB. The primary outcome measure was primary facial lymphatic drainage site from the eyelid as determined by lymphoscintigraphy.
  
  
  RESULTS
  The preauricular basin was the site of focal radioactive uptake in all 15 patients. The location of the primary tumor was as follows: medial upper eyelid (1), medial canthus (3), medial lower eyelid (3), lateral upper eyelid (3), and lateral lower eyelid (5). The types of tumor were: invasive squamous cell carcinoma (7), malignant melanoma (3), and sebaceous cell carcinoma (2), Merkel cell carcinoma (2), and conjunctival spindle cell carcinoma (1).
  
  
  CONCLUSIONS
  Lymphoscintigraphy is increasingly used in the context of SLNB for periocular malignancy. The recent literature suggests that the preauricular lymph node basin may be the primary site of eyelid lymphatic drainage and this is corroborated by our series. Further data will elucidate the biology of eyelid lymphatic channels in humans but the preauricular basin may be the prime lymphatic metastastic site in eyelid malignancies.
authors: Gavin Herbert Eye Institute, University of California Irvine, Irvine CA, United States.
authors: Julio C
authors: JC
authors: Echegoyen
authors: Kristin E
authors: KE
authors: Hirabayashi
authors: Ken Y
authors: KY
authors: Lin
authors: Jeremiah P
authors: JP
authors: Tao
keywords: Eyelid lymphatics; Eyelid malignancy; Lymphoscintigraphy; Sentinel lymph node; Sentinel lymph node biopsy
references: Ophthalmic Plast Reconstr Surg. 2001 Sep;17(5):338-44; discussion 344-5
references: 11642490
references: Ophthalmic Plast Reconstr Surg. 2013 Jan-Feb;29(1):6-10
references: 23034693
references: Ophthalmic Plast Reconstr Surg. 2010 Jul-Aug;26(4):281-5
references: 20551850
references: Ophthalmology. 2004 Oct;111(10):1930-2
references: 15465559
references: Arch Otolaryngol Head Neck Surg. 2007 Aug;133(8):820-6
references: 17709624
references: Ophthalmic Plast Reconstr Surg. 2003 Mar;19(2):102-6
references: 12644754
references: Ophthalmic Plast Reconstr Surg. 2002 Mar;18(2):99-106
references: 11897950
references: Ophthalmic Plast Reconstr Surg. 2004 Jul;20(4):291-5
references: 15266143