Applications of fluorescence-guided surgery in head and neck surgery –⁠ a narrative review

Overview

Fluorescence-guided surgery (FGS) has emerged as a valuable intraoperative imaging technique that enhances the real-time visualization of anatomical structures and pathological tissues. In head and neck surgery, where the anatomical complexity and proximity of vital structures pose significant challenges, FGS enhances surgical precision and outcomes. This review provides a comprehensive overview of clinical applications, technical aspects, and recent advances in fluorescence-guided surgery within the field of otolaryngology and head and neck surgery. FGS has demonstrated significant utility in identifying critical anatomical structures such as nerves, vasculature, and lymphatics; and evaluating flap perfusion. Its role in thyroid and parathyroid surgery is well established, where it aids in preserving gland function and reducing postoperative complications. Recently, its applications in oncosurgery, particularly insitu tumor margins assessment, ex vivo evaluation of resected specimens, and sentinel lymph nodes mapping, are rapidly evolving. Even though the number of clinically approved fluorophores remains limited, the growing number of ongoing clinical trials indicates a strong potential for further expansion of this technology. FGS represents a valuable tool in modern head and neck surgery, improving intraoperative visualization, enhancing surgical safety, and supporting oncologic and functional outcomes.

Keywords:

lymph node – head and neck cancer – parathyroid gland – surgical margins – fluorescence-guided surgery – near-infrared imaging