[Indications of intraoperative ultrasound in head and neck surgery].
BACKGROUND
A possible use of B-scan sonography arises from the difficulty in transferring information by means of imaging to the intraoperative situation, which is now possible with navigation systems in complicated surgical procedures in the field of otolaryngology. A solution to this problem offers the intraoperative use of ultrasonography for orientation in soft tissue surgery.


METHODS
A prospective study involving 115 patients in total entailed scanning with a small part linear and fingertip probe with either 10 and 7.5 MHZ. An ultrasound endoscope featuring a 7.5 MHZ convex probe was used to image endolarygeal processes.


RESULTS
Indications included panendoscopies, parotidectomies, submandibulectomies, lymph node exstirpations and abscess incisions. The colour doppler sonography was used in reconstructive surgery involving microvascular transplants. The display of soft tissue tumours provided information about tumour size as well as demarcation or infiltration of neighbouring structures. The fingertip probe and the ultrasound endoscopy served to evaluate areas that were morphologically difficult to access. After clamping the radial artery when harvesting the forearm flap, a sufficient perfusion of the thumb and later the sufficiency of the vascular anastomosis could be verified.


CONCLUSIONS
The intraoperative use of sonography is an inexpensive non-invasive procedure that can be performed by the surgeon himself and allows quick and reliable orientation during difficult operations.
Medizinische Hochschule Hannover, Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Hannover.
M
M
Stieve
P R
PR
Issing
K F
KF
Mack
T
T
Lenarz
N
N
Prenzler
D019160:Endosonography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D007818:Laryngeal Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods; D008866:Microsurgery / Q000379:methods; D010038:Otorhinolaryngologic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D010039:Otorhinolaryngologic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D013363:Submandibular Gland / Q000000981:diagnostic imaging / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D018615:Ultrasonography, Doppler, Color / Q000379:methods