title: A lean neck mass clinic model: Adding value to care.
abstract: OBJECTIVE
  To demonstrate that ultrasound-guided fine needle aspiration (USFNA) with on-site cytopathologic analysis eliminates unnecessary diagnostic testing, return visits, and repeat procedures and optimizes quality of care.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Sixty-one new patients (28 female; 33 male; age range=19-85 years) were seen in our dedicated neck mass clinic over a 1-year period. All patients underwent USFNA of masses located in neck levels I-VI (n=40), parotid gland (n=20), or parapharyngeal space (n=1). Each patient underwent two USFNA passes followed by on-site cytopathologic analysis with additional passes if required for diagnosis.
  
  
  RESULTS
  Diagnosis was made in 93.4% (n=57) of patients, allowing for counseling and treatment planning at the first visit. To obtain a diagnosis, more than half (57.4%, n=35) of our patients required additional passes, which implies that they would have required an additional visit without on-site cytopathologic analysis. Treatment included observation in 42.6% (n=26) of patients, surgery in 32.8 % (n=20) of patients, and nonsurgical treatment (chemotherapy, radiation, other) in 24.6% (n=15) of patients. The average time from check-in to checkout including the clinic visit, biopsy, and treatment counseling was 103 minutes, and the average round trip mileage traveled per patient was 127.6 miles.
  
  
  CONCLUSIONS
  The adult neck mass is a commonly encountered scenario in otolaryngology. For the patient, this can be a stressful situation in which timely and accurate diagnosis is critical. A dedicated lean neck mass clinic model with USFNA and on-site cytopathologic analysis can be both an efficient part of one's practice and a valuable addition to patient care.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery.
authors.forename: Brittny N
authors.initials: BN
authors.lastname: Tillman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery.
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Glazer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery.
authors.forename: Amrita
authors.initials: A
authors.lastname: Ray
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery.|Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.
authors.forename: J Chad
authors.initials: JC
authors.lastname: Brenner
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery.|Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Spector
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D010307:Parotid Neoplasms / Q000473:pathology*; D010610:Pharyngeal Neoplasms / Q000473:pathology*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Neck mass; fine needle aspiration; ultrasound