Background and objectives: The use of sentinel lymph node biopsy (SLN) has evolved greatly in the treatment of head and neck squamous cell carcinoma (SCC). During the past few years, many authors have encouraged its use as a routine technique in clinically T1-T2 N0 SCC of the head and neck.

Objective: Describe our experience in the management of T1-T2 N0 oral squamous cell carcinoma.

Methods: We report a series of seventy consecutive patients with T1-T2 N0 oral squamous cell carcinoma who were primarily treated with local surgery and SLN biopsy at the Oral and Maxillofacial department of the Hospital Vall d’Hebron during the last eight years.

Results: Nodal stations II and III were the most frequently affected (66.7% and 44.4% respectively). Eighteen patients previously classified as cN0 (25.7%) were found to have neck affection during the SLN biopsy. SPECT-TC was very helpful in determining the precise location of the SLN during surgery.

Conclusions: Hidden nodal metastases are not negligible in cT1-T2 N0 oral SCC. It is advisable to apply the SLN biopsy technique in order to avoid unnecessary lymph node dissection and offer a conservative technique for the early detection of lymph node spread.