Skin or allergic reactions to the blue dye used in SNLB.Difficulty moving the affected body part.Numbness, tingling, swelling, bruising, or pain at the site of the surgery, and an increased risk of infection.Seroma, or a mass or lump caused by the buildup of lymph fluid at the site of the surgery.Very rarely, chronic lymphedema due to extensive lymph node removal may cause a cancer of the lymphatic vessels called lymphangiosarcoma. In addition, there is an increased risk of infection in the affected area or limb. In the case of extensive lymph node removal in an armpit or groin, the swelling may affect an entire arm or leg. There is less risk with the removal of only the sentinel lymph node. The risk of lymphedema increases with the number of lymph nodes removed. Lymphedema may cause pain or discomfort in the affected area, and the overlying skin may become thickened or hard. This disrupts the normal flow of lymph through the affected area, which may lead to an abnormal buildup of lymph fluid that can cause swelling. During lymph node surgery, lymph vessels leading to and from the sentinel node or group of nodes are cut. These levels are Ia, Ib, II, III, IV, V, VI, VII, VIII, IX, X.All surgery to remove lymph nodes, including SLNB, can have harmful side effects, although removal of fewer lymph nodes is usually associated with fewer side effects, particularly serious ones such as lymphedema. The lymph nodes of the neck are further classified by level. These include the nasopharynx, pharyngeal wall, base of the tongue, soft palate, and larynx. Conversely, most structures drain ipsilaterally, except in the case of structures situated at the anatomic midlines. On the right side, they flow directly into the lymphatic duct. On the left side, they drain either directly into the vasculature via the jugulo-subclavian venous confluence or directly into the thoracic duct. From there it moves into the spinal accessory chain adjacent to the spinal accessory nerve, or cranial nerve XI, and then meets the supraclavicular chain. This lymphatic drainage originates at the base of the skull, then proceeds to the jugular chain adjacent to the internal jugular vein. These lymphatic chains are strongly lateralized and typically do not directly communicate between left and right in the absence of a pathologic process. Aponeuroses bind them together with the muscles, nerves, and vessels of the head and neck. The head and neck contains a rich and elaborate lymphatic network of more than 300 nodes and their intermediate channels. A detailed understanding of the principle lymphatic nodal levels of the neck is required, including their anatomical configuration and boundaries, patterns of drainage, and risk of metastatic involvement in the context of malignancy. This knowledge is especially crucial in guiding the approach to proper locoregional therapy, whether by surgery or irradiation. As such, intimate knowledge of the anatomic relationships of the lymphatic nodal levels and the structures they drain is critical in the delivery of appropriate therapy in many patients with cancers of the head and neck. The involvement of specific nodal groups is an indicator of pathologically-affected organs and tissues, especially in the context of malignancy. Lymphadenopathy is a significant clinical finding associated with acute infection, granulomatous disease, autoimmune disease, and malignancy. It is inclusive of osseous, nervous, arterial, venous, muscular, and lymphatic structures. The head and neck, as a general anatomic region, is characterized by a large number of critical structures situated in a relatively small geographic area.
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