Lymphatics of the mouth and neck

Research evaluation in 125 dogs and twenty-five human subjects through visualization of lymphatics with sky blue dye has led to newer concepts in the lymph flow of the tongue, as well as the cervical lymphatics. Cannulation of the lymphatics of the tongue and injection with radiopaque material followed by cineradiography gives an insight into normal and abnormal flow patterns of the lymph drainage. The importance of the valves in the cervical lymphatics, cross over of lymphatics, and obstruction of the lymphatics has a definite bearing on the course of metastatic disease. The cervical lymphangiograms correspond well to the anatomy book descriptions except in two areas: first, the lymph drainage from the tip of the tongue did not go to the submental nodes; second, lymphatics originating near the midline of the tongue did not cross over to the opposite side except those near the tip of the tongue or if chronic obstruction was present. The application of lymphangiography to the study of the tongue, floor of the mouth, and neck lymphatics has brought us closer to specific anatomic and physiologic knowledge, which will give a better understanding of means to combat neoplasia in these areas.