Using Sentinel Lymph Node Biopsy to Guide Treatment Algorithms in Clinically N0 Sinonasal Malignancy

Introduction: Early stage (T1 and T2) clinically N0 patients with sinonasal squamous cell carcinoma present a treatment dilemma with regards to elective treatment of the neck. Even in situations with low incidence of nodal metastasis, radiation oncologists may elect to radiate bilateral locoregional lymphatic basins in the adjuvant setting. We propose the inclusion of lymphoscintigraphy in the treatment algorithm of sinonasal malignancy for sampling of the primary echelon nodal basin. A positive result would lead toward lymphadenectomy while a negative nodal pathologic analysis may help argue against unnecessary external beam radiation.