The Role of Sentinel Lymph Node Biopsy In Detecting Occult Contralateral Neck Nodal Metastasis in Midline Approaching Oral Squamous Cell Carcinoma- A Prospective Validation Study

Population: 18 to 70 years

Intervention: Peritumoral injection of a radiotracer or dye will be performed, followed by lymphoscintigraphy and intraoperative sentinel lymph node biopsy (SLNB) using advanced imaging and a gamma probe to detect sentinel lymph nodes, particularly in the contralateral neck.

Comparison: N/A

Outcome: The primary outcome is the sensitivity of SLNB in detecting contralateral lymph node metastasis in OSCC cases approaching or crossing the midline. Secondary outcomes include the identification rate of contralateral lymph node metastasis, specificity, false negative rates, and mapping patterns of contralateral lymphatic drainage.

Time: N/A (single point assessment during surgery)

Research Question: Can contralateral neck dissection be avoided with the help of SLNB in lesions approaching midline?

This study aims to assess the effectiveness of SLNB and lymphatic mapping in identifying contralateral cervical lymph node metastasis in midline approaching OSCC (MOSCC) with sensitivity as the primary and identification rate, specificity, false negative rate, and lymphatic drainage patterns of the contralateral neck as secondary objectives

Inclusion Criteria: Histologically proven OSCC approaching midline In ages 18-70 years with contralateral negative neck with curative intent surgery

Exclusion Criteria: Synchronous/recurrent head and neck tumors, previously irradiated/ surgically explored neck and proven contralateral nodal disease