Ear, nose, and throat cancer: ultrasound diagnosis of metastasis to cervical lymph nodes.

Abstract

The value of ultrasound in the detection of metastasis to the cervical lymph nodes in connection with cancer of the ear, nose and throat was studied. Comparison of clinical, ultrasound and histological findings for 100 patients who underwent surgery revealed that clinical examination had a sensitivity of 78 vs. 92.6% for ultrasound. All 18 cases of thrombosis of the internal jugular vein were detected by ultrasound. Clinical staging of the disease was modified in 28 of these patients based on ultrasound findings, including three false positive findings. Ultrasonographic follow-up at 3 mo. for a 2nd group of 110 patients who did not undergo neck dissection provided prognostic information, since lesion stability or progression was correlated with death in < 1 yr in 41 of 43 patients. Ultrasound is of primary value in providing information of an anatomic nature, including the detection of subclinical, lymph nodes, volumetric evaluation and determination of vascular connections, particularly detection of internal jugular venous thrombosis. Furthermore, for patients whose necks have been thickened as a result of radiotherapy, ultrasound allows assessment of local status.