Fluorescence Imaging in Head and Neck Cancer

Fluorescent technology continues to advance in the detection of sentinel lymph nodes (SLNs).
Currently, this requires switching from near-infrared light to white light to be able to
identify the fluorescent tissue contrasting with normal surrounding tissue. Currently, no
system has been studied specifically for head and neck sentinel lymph node biopsies using a
hands free goggle system that can visualize white light (normal surgical visualization) and
nearinfrared light (ICG fluorescence) simultaneously. This technology may have implications
on the safety and accuracy of sentinel lymph node biopsy for head and neck mucosal and
cutaneous tumors. Secondarily, this may reduce operative costs by decreasing the amount of
time required to perform the SLNB procedure.

Regarding parathyroid identification, this technology has the potential to identify these
very small glands during procedures they are at risk. These glands are not only at risk of
inadvertent removal if not adequately identified, but may also be at risk if devascularized
by manipulation during the surgical procedure. Therefore, early and accurate identification
may decrease the rate of temporary and permanent hypoparathyroidism and hypocalcemia. This is
not only an issue during thyroid and parathyroid surgery, but during laryngectomy surgery
where the anatomic region these glands are located are often resected to remove at risk lymph
nodes from cancer spread. Therefore, identifying these glands may help preserve parathyroid
function in this patient population as well.