title: Ultrasonography and ultrasound-guided fine-needle aspiration biopsy of head and neck lesions: a surgical perspective.
abstract: A head and neck ultrasound-guided fine-needle aspiration clinic was set up to determine the role of ultrasound and ultrasound-guided fine-needle aspiration in the evaluation of patients with lesions in this region. One hundred ninety-five lesions were biopsied by ultrasound-guided fine-needle aspiration in 203 patients. Ultrasound detected 2 or more lesions in 14 (48%) of 29 patients with a clinically solitary thyroid nodule. Three (8.8%) of 34 lesions thought to be within the parotid gland were determined to be external. A pronounced learning curve was evident in the technique of ultrasound-guided fine-needle aspiration, particularly for nonpalpable disease. Adequacy of sampling for each 3-month period was 71%, 89%, and 94%, respectively. Seventy-four percent of central aspirations were satisfactory compared to 54% of peripheral aspirations. Ultrasound-guided fine-needle aspiration did not alter the clinical staging of metastatic neck disease in 8 patients having 10 neck dissections but proved useful in detecting nodal recurrence in 3 irradiated necks that did not proceed to surgery. The smallest node to harbor malignancy had 4-mm maximal axial diameter. We conclude that ultrasound and ultrasound-guided fine-needle aspiration are valuable adjuncts to the clinical examination.
authors.affiliation: Department of Otolaryngology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: N P
authors.initials: NP
authors.lastname: McIvor
authors.forename: J L
authors.initials: JL
authors.lastname: Freeman
authors.forename: S
authors.initials: S
authors.lastname: Salem
authors.forename: L
authors.initials: L
authors.lastname: Elden
authors.forename: A M
authors.initials: AM
authors.lastname: Noyek
authors.forename: Y C
authors.initials: YC
authors.lastname: Bedard
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging*; D012466:Salivary Gland Diseases / Q000175:diagnosis; D016606:Thyroid Nodule / Q000175:diagnosis; D014463:Ultrasonography