Study challenges traditional thinking on eyelid lymphatic drainage

This is the first study to use lymphoscintigraphy to examine lymphatic drainage patterns of normal human eyelids. The results raise questions regarding our traditional understanding of eyelid lymphatic drainage.

The authors injected 0.02 ml (0.250mCi) of Tc 99 m sulphur colloid into the contralateral eyelid of 28 patients undergoing unilateral eyelid surgery. Injections were made in one of five locations: upper lateral, upper medial, medial canthus, lower medial or lower lateral. The authors performed lymphoscintigraphy two to six hours later with a conventional planar gamma camera in order to identify nodes in the head and neck.

Three patients had no identifiable nodes. Among the remaining patients, the preauricular node was the most common first order sentinel lymph node regardless of injection site (18 of 25 patients; 72 percent). Many subjects had more than one sentinel lymph node.

The authors conclude that their lymphoscintigraphy data do not support the classic lymphatic drainage patterns.