Thomas CM, Khan MN, Mohan R, et al. - Among 10 patients with lateralized oropharyngeal squamous cell carcinoma (OPSCC) tumors and cN0 contralateral necks, researchers established tolerability and feasibility of the awake injection technique, as well as characterized lymphatic drainage patterns. According to results, primary sites involved tonsil and tongue base. Without any complications, all patients tolerated wake injections. Nine individuals showed satisfactory migration of radiotracer to neck node(s) with seven to the ipsilateral lateral neck, one to the ipsilateral lateral neck and retropharynx, and one to bilateral lateral neck nodes. Utilizing a nonoperative injection technique and SPECT-CT, characterization of lymphatic drainage in OPSCC is feasible. Drainage to the contralateral neck is rare, which warrants further study to adequately tailor treatment.