Ultrasound and fine needle aspiration cytology in the staging of neck lymph nodes in oral squamous cell carcinoma

We prospectively studied 49 patients with oral squamous cell carcinoma (SCC ) who had their cervical regional lymph nodes examined by ultrasound (US), with or without fine needle aspiration cytology (FNAC), for the detection o f metastatic spread. They were screened over a two-year period (1993-1995) by computed tomography (CT) and magnetic resonance imaging (MRI) or both to measure the primary tumour. US, with or without FNAC, was used to stage th e neck. All tumours were biopsied preoperatively and the diagnosis of SCC c onformed by histological examination. Management of the neck was based on U S staging. Thirty-five patients had neck dissections and 14 were managed co nservatively. Mean follow-up was 30 months (range 24-48), All patients were alive at one year, but one died at 14 months from recurrence of disease in the neck. There were 3 false negatives (6%), We find that US, with or with out FNAC, is an accurate (86%), sensitive (92%) and specific (83%) techniqu e for the preoperative assessment of lymph node metastases in patients with SCC, (C) 2000 The British Association of Oral and Maxillofacial Surgeons.