Аннотация
Relevance: Intraoperative visualization of lymphatic drainage in head and neck tumors is important for determining the pathways of lymphogenic spread and planning the extent of surgical intervention. The use of indocyanine green (ICG) enables real-time assessment of lymphatic perfusion; however, data on its types and clinical significance remain limited.The study aimed to identify and characterize variants of lymphatic perfusion during intraoperative ICG lymphography in patients with primary tumors of the head and neck.Materials and Methods: A prospective analysis of intraoperative ICG lymphography in patients with head and neck tumors was performed. The features of lymphatic drainage visualization were evaluated, followed by a classification of types of lymphatic perfusion and an analysis of their clinical significance.Results: Four types of lymphatic perfusion identified during the study included the focal, linear, multifocal, and nodular types; stellate and diffuse types were not identified. The focal type was characterized by local accumulation of dye in the area of the primary focus; linear – by visualization of lymphatic vessels; multifocal – by the presence of several accumulation zones; nodular – by accumulation of ICG in regional lymph nodes. In some cases, a combination of several types was observed, reflecting the complex nature of lymphatic drainage in head and neck tumors.Conclusion: Intraoperative ICG lymphography enables visualization of diverse lymphatic perfusion patterns and can serve as an additional tool for assessing lymphatic outflow pathways. The obtained data have potential value for optimizing the extent of surgical treatment.