In response to the above letter to the editor, we acknowledge that there may be some confusion about the terminology of the lymph nodes draining the supratip region of the nose. However, the reasoning for not describing a specific lymph node is owing to some of the limitations of the radionuclide scanning techniques that were used in this study.1 The radionuclide injections (technetium Tc 99m bound to antimony trisulfide colloid) used for lymphoscintigraphy were placed intradermally and probably did drain into the superficial, cutaneous papillary network described in Goepfert's letter. In our study, we noted that the lymphatics followed the external maxillary blood vessels (facial blood vessels) at the inferior part of the face to drain toward the submaxillary lymph nodes. The confusion occurs with the terminology used to describe the first set of lymph nodes between the lateral wall of the nose and the submaxillary nodes. We considered describing
Toriumi DM, Mueller RA, Grosch T, Bhattacharyya TK, Larrabee WF. Vascular Anatomy of the Nose and the External Rhinoplasty Approach-Reply. Arch Otolaryngol Head Neck Surg. 1996;122(11):1277. doi:10.1001/archotol.1996.01890230118024
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