THE SONOGRAPHY IN THE PRIMARY STAGING OF HEAD AND NECK TUMORS

The radiologic imaging methods play an important role in the precise s taging as basic requirement for an effective concept of tumor therapy. The accuracy of ultrasound in the primary staging according to the TN M-classification (UICC) was therefore prospectively investigated in 26 0 patients with head and neck tumors of the clinical stages T1NO to T4 N3. The clinically (C1) and sonographically (C2) evaluated pretherapeu tic stages were compared to the postoperative histopathologic tumor cl assifications. The clinical staging was correct in 75.0%, high in %, l ow in 17.3%, the N-stages were correct in 59.2%, high in 17.7%, low in 23.1%. The sonographic staging was apparently superior with the T-cla ssifications correct in 92.3%, high in 7.7%, low 0.0%. The N-stages we re correct in 89.6%, high in 9.2%, low in 1.2%. The accuracy of combin ed TN classification rose from clinical 46.5% to 84.6% by sonography. Accompanying inflammations, foregoing biopsies and tooth extractions w ere the main reasons for incorrect staging. Therefore, the thorough so nographic investigation performed after the clinical examination and b efore invasive procedures, due to little patient discomfort, good avai lability and high accuracy, is an excellent sectional imaging method f or staging, therapy-planning and follow up of tumors of the head and n eck especially of the orofacial regions.