title: Ultrasonography in the treatment of a pediatric midline neck mass.
abstract: OBJECTIVE
  To assess the effectiveness of ultrasonography for determining which pediatric midline neck masses should be treated surgically.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  Pediatric patients with a midline neck mass who underwent ultrasonography from 2003 to 2011.
  
  
  METHODS
  Demographics, ultrasonography, and surgical and pathology reports were studied. The ultrasonography findings and pathological analyses were compared.
  
  
  RESULTS
  One hundred twenty-two patients met the inclusion criteria. The most common diagnosis obtained by ultrasonography was thyroglossal duct cyst (48.4%), followed by reactive lymph node (27.9%). Ninety-five of 122 patients (77.9%) underwent surgery. Twenty-seven patients (22.1%) were treated nonsurgically. The diagnosis and characteristics obtained from ultrasonography were confirmed by surgical pathologic analysis in 84.2% of the surgical cases. Of the 95 patients who underwent surgery, 85 (89.5%) had a non-lymph node lesion diagnosed by ultrasonography and confirmed by pathologic analysis. Ultrasonography was only 66.1% accurate in specifically diagnosing thyroglossal duct cyst and 30.0% accurate in specifically diagnosing reactive lymph node when compared with surgical specimens.
  
  
  CONCLUSIONS
  Ultrasonography is helpful in determining the pediatric midline neck masses that need to be removed surgically. It is less helpful in determining the exact pathologic characteristics of the lesion.
authors.affiliation: Department of Otorhinolaryngology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Archwin
authors.initials: A
authors.lastname: Tanphaichitr
authors.forename: Bharat
authors.initials: B
authors.lastname: Bhushan
authors.forename: John
authors.initials: J
authors.lastname: Maddalozzo
authors.forename: James W
authors.initials: JW
authors.lastname: Schroeder
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006776:Hospitals, Pediatric; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D063128:Tertiary Health Care; D013955:Thyroglossal Cyst / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*