PR19 THE SUPERFICIAL LYMPHATIC DRAINAGE OF THE HEAD AND NECK – AN ANATOMICAL STUDY AND CLINICAL IMPLICATIONS.

Aims 1. To re-evaluate the basic anatomy of the lymphatic vessel network in the head and neck region for diagnosis and treatment of lymphogenic cancer metastases. 2. To compare the anatomy of the lymphatic system with the venous system. 3. To investigate the possibility that extensive lymphatic-venous connections exist. Materials and Methods The lymphatic vessels in the scalp, face and neck of 5 (ten halves) fresh human cadavers were identified by using 6% hydrogen peroxide with and without India ink, then injecting the vessels with a lead oxide, milk powder and water mixture. The specimens were photographed, radiographed and analyzed. Results Radiographs and photographs show: (1) The lymphatic pathway “patterns” found were different in each specimen, even each side of the same head showed considerable variation. (2) The lymphatic pathways of the anterior neck lie in the tissue above the platysma and course horizontally and obliquely. This finding confirm those found using lymphoscintigraphy (3) The discovery of lymphatic bypass routes confirms the lymphoscintigraphy findings that lymphatic drainage does not always go directly to the first tier lymph nodes. (4) We were able to compare the anatomical relationship of the lymphatic and venous systems and demonstrate that a lymphatic-venous shunt does exist in the occipital region. Conclusion This study provides an anatomical picture of the superficial lymphatic system of the head and neck and will aid surgical management in the treatment of trauma, infection, lymphoedema and cancer. [ABSTRACT FROM AUTHOR]