Title: Lymph Node Staging in Patients of Head & Neck Malignancies with Clinically Negative Neck Examinations by Ultrasound and Ultrasound Guided Aspiration Cytology

Authors: Sunil Kumar, HP Singh, Veerendra Verma, SP Agarwal, A Mishra, Neera Kohli, M Srivastava

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i4.04

Abstract

 Head and neck cancer is very common with incidence rates varying from 10-15% in various sociodemographic regions and approximately 50% of all malignant tumours in males in India. More than 90% of head neck cancers are squamous cell carcinomas with variety of malignant tumours. Clinical examination (Palpation) can miss the detection of lymph nodes in up to 60% of cases. In head and neck cancers, spread to the lymph nodes in the neck is relatively common and most important factor in determining the survival of patients with head neck cancer at any site depends on the metastatic disease in the neck. Size of lymph node is about 2-3 mm which normally can’t be palpated. High resolution ultrasound can detect these nodes which are clinically not palpable and is non-invasive harmless procedure. Because of safety of ultrasound and ultrasound guided FNAC, the procedure is likely to be used in every patient of head neck malignancies, more wide spread use would result in better planning for management of metastatic lymph nodes of neck and better care of patient by decreasing the morbidity, mortality and cost associated with unnecessary surgery by avoiding the need for other diagnostic procedures. So it is suggested that in every patient of head and neck malignancy after clinical examination ultrasound with and /or without FNAC should be done as a mandatory procedure for the better management of the patient.

Keywords-Head neck malignancy, clinically negative neck, US guided FNAC

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