The history of sentinel node biopsy in head and neck cancer: From visualization of lymphatic vessels to sentinel nodes

•The cervical lymphatic system was visualized by lymphangiography or -scintigraphy.•More specific drainage patterns were visualized by peritumoral injections.•Metastases were detected by block of lymphatic flow during.•Blue dye and radiolabeled colloids were introduced to visualize the sentinel node.•After validation sentinel biopsy is now a valuable diagnostic technique.

SummaryThe aim of this report is to describe the history of sentinel node biopsy in head and neck cancer. Sentinel node biopsy is a minimally invasive technique to select patients for treatment of metastatic lymph nodes in the neck. Although this procedure has only recently been accepted for early oral cancer, the first studies on visualization of the cervical lymphatic vessels were reported in the 1960s. In the 1980s mapping of lymphatic drainage from specific head and neck sites was introduced. Sentinel node biopsy was further developed in the 1990s and after validation in this century the procedure is routinely performed in early oral cancer in several head and neck centers. New techniques may improve the accuracy of sentinel node biopsy further, particularly in difficult subsites like the floor of mouth.