title: Cervical lymph node metastasis in oral squamous carcinoma preoperative assessment and histopathology after neck dissection.
abstract: BACKGROUND
  The presence or absence of nodal metastasis has a great impact on the prognosis and survival of patients with head and neck cancer. The risk of occult metastasis is related to the method by which the lymph nodes are evaluated. It is possible to reduce the risk of undiagnosed metastasis with accurate imaging techniques and thus probably reduce the number of elective neck treatments.
  
  
  OBJECTIVE
  To assess the accuracy of clinical palpation, CT Scan, Ultrasound and Ultrasound guided FNAC in prediction of lymph node metastasis in oral squamous cell carcinoma so that a suitable surgical neck dissection can be carried out.
  
  
  METHODS
  Ten patients with oral squamous cell carcinoma who underwent 10 neck dissections (4 RND, 6 SOND) were included. All the patients underwent examination of neck pre operatively by palpation, Computed Tomography with contrast, Ultrasound and Ultrasound guided FNAC for no detection. The findings were correlated with the results of histopathologic examination of the neck specimen. The results were obtained after statistical analysis.
  
  
  RESULTS
  Six neck dissection specimens showed metastatic lymph node involvement in postoperative histopathology. Lymph node involvement was identified preoperatively by palpation in 7 necks, CT in 3 necks, US in 9 necks and USFNAC was positive in 4 cases. The palpation showed 83% sensitivity, 50% specificity. CT showed sensitivity of 50%, specificity of 100%, US showed sensitivity of 100%, specificity of 25% and US-FNAC showed sensitivity of 67%, specificity of 100%.
  
  
  CONCLUSIONS
  The palpation, CT Scan and US are equally accurate but the USFNAC is the most accurate technique in assessing metastasis in lymph nodes in patients with oral squamous cell carcinoma.
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, Karnataka India.
authors.forename: N T
authors.initials: NT
authors.lastname: Geetha
authors.forename: Neelakamal
authors.initials: N
authors.lastname: Hallur
authors.forename: Gayathri
authors.initials: G
authors.lastname: Goudar
authors.forename: B C
authors.initials: BC
authors.lastname: Sikkerimath
authors.forename: Santhosh S
authors.initials: SS
authors.lastname: Gudi
keywords: Computed tomography; Fine needle aspiration cytology; Occult metastasis; Oral squamous cell carcinoma; Ultrasound