Abstract
Objective: The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl human serum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS). Methods: Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope. Results: ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3). Detection of sentinel lymph nodes was attempted after injecting ICG:MSA in the mouse tongue cancer model (n = 3). During the operation, lymph nodes were easily identified and resected using ICFIS without the aid of other magnifiers. In the rabbit tongue cancer model (n = 3), the ICFIS equipped with 30-degree endoscopy was used to confirm the feasibility of endoscopic sentinel lymph node biopsy. The entire sentinel lymph node biopsy procedure was performed using the ICFIS with the 30-degree endoscope. We detected and dissected sentinel lymph nodes in the rabbit model without the other sentinel lymph node detection tools. Conclusion: We confirmed the usefulness of sentinel lymph node biopsy using a near infrared fluorescence technique and endoscopic system. Avoidance of radiation exposure and shine-through phenomena, which are problems of sentinel lymph node biopsy using conventional radioisotopes, are advantages of our surgical technique. By combining the endoscopic system with a sentinel lymph node biopsy procedure, we avoided visible neck scars, which lead to excellent cosmetic outcomes. Level of Evidence: NA. Laryngoscope, 128:E135–E140, 2018.
| Original language | English |
|---|---|
| Pages (from-to) | E135-E140 |
| Journal | Laryngoscope |
| Volume | 128 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2018 Apr |
Bibliographical note
Funding Information:This study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI13C1501). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Funding Information:
From the Department of Otorhinolaryngology–Head and Neck Surgery (Y.M.P., J-G.C., J-S.W., J-J.S.); the Department of Thoracic and Cardiovascular Surgery (Y.H.Q., H.K.K.), Korea University College of Medicine; the Department of Biomedical Sciences, College of Medicine, Korea University (Y.H.Q., H.K.K.); the Department of Interdisciplinary Bio/Micro System Technology, Korea University College of Engineering (K.H.K., B-M.K.); the Department of Bio-convergence Engineering, School of Biomedical Engineering, Korea University College of Health Science (B-M.K.); and the Department of Nuclear Medicine, College of Medicine, Seoul National University (Y-S.L., J.M.J.), Seoul, Republic of Korea Editor’s Note: This Manuscript was accepted for publication on November 8, 2017.
Publisher Copyright:
© 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Keywords
- Sentinel lymph node
- endoscopic system
- indocyanine green
ASJC Scopus subject areas
- Otorhinolaryngology
