XXIV The Cervical Lymphatics, Human in Vivo Studies

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Abstract
An experimental study has been presented to determine the feasibility of a pre-operative localization of lymph drainage from the supraglottic larynx in the normal condition and as it may be modified by neoplastic metastases. In this clinical investigation patients with neoplasms of the larynx and oral cavity have been injected. In the cases in which there has been either small, i.e. less than 1.5 cm nodes, there is no interference with the nodal outline of an upper cervical node and occasionally a chain along the jugular vein and into the posterior triangle. Whenever there is edema of the larynx or pharynx, or large malignant adenopathy, or when radiotherapy or surgery has been performed, there is interference with drainage and the radiogold is contained within the larynx. In the absence of radiotherapy or surgery, limitation of the radiogold to the injection site may indicate a more extensive extralaryngeal involvement of tumor than initially suspected. Following these modalities of therapy alteration in the lymphodynamics is evident as a localization of the tracer material in the injection site.