THE VALUE OF COMPUTED-TOMOGRAPHY SCAN VERSUS AN EXPLORATIVE SURGICAL APPROACH FOR REMOVAL OF SQUAMOUS-CELL CARCINOMA OF THE POSTERIOR PHARYNGEAL WALL

BACKGROUND: The prevertebral fascia plays a key role in surgery of pos terior pharyngeal wall tumors. Invasion of the prevertebral muscles de termines the irresectability of the tumor and accurate diagnosis of in vasion posteriorly is a prerequisite for major ablative surgery. METHO DS: A retrospective study was performed to define the value of CT scan ning versus open neck exploration with regard to the resectability of posterior pharyngeal wall carcinoma. The predictive value of preoperat ive CT scans was assessed and compared with the outcome of open neck e xploration and resectability of the primary tumor, using the final his topathology report as a gold standard. RESULTS: Nineteen patients with 20 tumors were included in this study. Overall the CT scan was correc t concerning prevertebral muscle status in 4 out of 20 (20%), whereas open neck exploration was correct in 18 tumors (90%). CONCLUSION: The predictive value of a suspicious CT scan in determining prevertebral m uscle invasion is extremely low in this study. Open neck exploration s eems to be superior for determining resectability of posterior wall ca rcinoma. (C) 1996 by Excerpta Medica, Inc.