title: Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth.
abstract: Applicability of sentinel node biopsy (SNB) for tumors of the floor of mouth (FOM) is controversial.
  
  
  
  Prospective evaluation of the accuracy of gamma-probe-guided superselective neck dissection of the preglandular triangle of level I for SNB in FOM squamous cell carcinoma (SCC) after preoperative lymphoscintigraphy and single photon emission CT (SPECT)/CT.
  
  
  
  In total, 22 sentinel lymph nodes were harvested in level I. Eight of 22 (36%) were seen on lymphoscintigraphy and 11 (50%) on SPECT/CT. Eleven sentinel lymph nodes (50%) were only detected intraoperatively. In unilateral tumors, 20% were contralateral, and, in midline tumors, 93% showed bilateral level I sentinel lymph nodes. The false-negative rate was 8.3%, the negative predictive value was 96.4%, and the false-omission rate was 3.6%. The ultimate neck control rate, including salvage treatment, was 100%.
  
  
  
  SNB in FOM can be reliably performed using the presented surgical technique. Level I exploration, bilaterally in midline tumors, is mandatory irrespective of the visualization of sentinel lymph nodes in other levels. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1367-1372, 2016.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Sandro J
authors.initials: SJ
authors.lastname: Stoeckli
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Huebner
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery University Hospital Zurich, Zurich, Switzerland.
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Broglie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D061305:Lymphoscintigraphy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology / Q000601:surgery*; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D000072098:Single Photon Emission Computed Tomography Computed Tomography / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: floor of mouth; lymphoscintigraphy; oral cavity; sentinel node biopsy; superselective neck dissection