title: Prospective randomized clinical trial of the effect of needle size on pain, sample adequacy and accuracy in head and neck fine-needle aspiration cytology.
abstract: BACKGROUND
  Fine-needle aspiration cytology (FNAC) is useful in the diagnosis of many conditions of the head and neck. No reported studies have investigated the optimal needle gauge in the head and neck region.
  
  
  METHODS
  This was a prospective randomized trial of 100 patients who required FNAC performed with either a 21G or 23G needle. Discomfort was scored by patients using a visual analogue scale. Sample accuracy was assessed in patients who subsequently had excision biopsy.
  
  
  RESULTS
  FNAC performed with a 23G needle was less painful (mean +/- SE, 1.6 +/- 1.01) than FNAC with a 21G needle (3.3 +/- 1.94; p < .001). There was no difference in sample adequacy between the 2 needle sizes (p = .59). The sensitivities and specificities of both needles were similar.
  
  
  CONCLUSIONS
  Head and neck FNAC should routinely be performed with a 23G needle, resulting in less patient discomfort, and giving sample adequacy comparable to a conventional 21G needle.
authors.affiliation: Maxillofacial Surgery Department, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth, United Kingdom. peter.brennan@porthosp.nhs.uk
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
authors.forename: Neil
authors.initials: N
authors.lastname: Mackenzie
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Oeppen
authors.forename: Gautham
authors.initials: G
authors.lastname: Kulamarva
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Thomas
authors.forename: Anne V
authors.initials: AV
authors.lastname: Spedding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012680:Sensitivity and Specificity