title: Accuracy of palpation, ultrasonography, and computed tomography in the evaluation of metastatic cervical lymph nodes in head and neck cancer.
abstract: BACKGROUND
  India accounts for the majority of oral cancer cases occurring worldwide. The metastasis of oral cancer to the regional lymph nodes and distant sites determines the prognosis and the survival rate of this disease.
  
  
  OBJECTIVE
  The aim and objectives of this study were to evaluate the accuracy of preoperative clinical methods such as palpation, ultrasonography (USG), and computed tomography (CT) in comparison with postoperative histopathological findings in determination of metastatic cervical lymph nodes and also to assess whether combining these techniques increases the specificity and sensitivity of lymph node metastasis in oral squamous cell carcinoma (SCC).
  
  
  METHODS
  Totally, 26 consecutive biopsy proven cases of oral SCC were included, and the nodal status was evaluated by palpation, CT and ultrasound (US) and confirmed by histopathological examination. The results were presented in terms of sensitivity, specificity, predictive values, accuracy, and P value.
  
  
  RESULTS
  Palpation, USG, and CT findings were compared with histopathologic findings by Fisher's exact test and the "P" value for palpation, US and CT were 0.003, 0.000, 0.000, respectively, which are statistically significant.
  
  
  CONCLUSIONS
  US examination combined with CT gives a better assessment of the neck for nodal metastasis.
authors.affiliation: Department of Oral and Maxillofacial Surgery, A B Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India.
authors.forename: Deepthi
authors.initials: D
authors.lastname: Shetty
authors.affiliation: Department of Oral and Maxillofacial Surgery, Craniofacial Unit, Dharwad, Karnataka, India.
authors.forename: Bhushan V
authors.initials: BV
authors.lastname: Jayade
authors.affiliation: Department of Medical Imaging and Radiodiagnosis, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.
authors.forename: Shyamsundar K
authors.initials: SK
authors.lastname: Joshi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Craniofacial Unit, Dharwad, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Gopalkrishnan
keywords: Computed tomography; lymph node; ultrasonography