ENDOSONOGRAPHIC ASSESSMENT OF THE PHARYNX

Background: Endosonography is a diagnostic tool for the examination of tumors of the oral cavity. The pharynx is usually not assessable for conventional endosonography due to problems with the placement of the probe in deeper areas of the pharynx. Patients: A fingertop ultrasonog raphy probe was combined with a stick allowing the user to locate the probe in deeper areas of the pharynx. The stick had two flexible joint s and a device for attaching the probe in the front. We evaluated 48 p atients with tumors of the posterior wall of the pharynx (n = 6), late ral wall of the pharynx (n = 7), tonsil (n = 17), sinus piriformis (n = 13), and nasopharynx (n = 5) during preoperative tumor endoscopy und er general anesthesia. Thirty-two patients suspected of having a tonsi llar abscess were examined under local anesthesia. Results: The evalua tion of the tumor dissemination and the determination of the relations hip between the tumor and the internal carotid artery was excellent fo r tumors of the posterior and lateral wall of the pharynx. The investi gation of tumors of the sinus piriformis and the nasopharynx was diffi cult and tumor growth could not be determined normally with endosonogr aphy. In four cases, retropharyngeal lymph nodes could be detected. Th e sensitivity for the diagnosis of tonsillar abscesses was 84%. Conclu sion: Endosonography of the deeper areas of the pharynx seems to be a useful instrument for investigating growth of tumors at the lateral an d posterior wall of the pharynx. Endosonographic results might be help ful for deciding between endoscopic and external approaches. Endosonog raphy is not sufficiently sensitive for diagnosing tonsillar abscesses , but might be helpful in clinically difficult cases.