Feasibility of In‐office Fine‐Needle Aspiration for Base of Tongue Tumors

Abstract

We aim to demonstrate the feasibility of in-office transcervical ultrasound (TCUS)–guided fine-needle aspiration (FNA) of base of tongue (BOT) tumors in a single-institution. Retrospective chart review was performed and 3 patients met criteria, with BOT tumors ≥3 cm . Two patients had no cervical adenopathy, while FNA of a cervical lymph node was inconclusive in patient 3. Two patients had multiple medical comorbidities rendering them high risk for general anesthesia, and 1 patient had a BOT tumor obscuring visualization of the glottis, which would have precluded intubation and potentially required tracheostomy to proceed. All patients underwent successful in-office TCUS-guided FNA, with results showing squamous cell carcinoma. There were no related complications. In-office TCUS-guided FNA can be used for diagnosis of BOT lesions that are evident on ultrasound. This is beneficial in cases where general anesthesia is considered high risk. Additionally, 1 patient safely continued anticoagulation, and another was able to avoid tracheostomy. This technique is cost-effective as it avoids the expenses associated with operative intervention.

Techniques in Otolaryngology: Ultrasound‐Guided Transcervical Fine‐Needle Aspiration of Laryngeal Masses

“…The application of ultrasound to image-guided biopsy of base of tongue, hypopharynx, thyroid nodules, and cervical lymph node metastases has been well documented, and its use in laryngeal cancer has been increasing in recent years. 1 - 4 Ultrasound-guided biopsy has high sensitivity and specificity, which are replicated through this technique to target laryngeal masses. 1 All patients in our study with squamous cell carcinoma were correctly diagnosed.…”

“…Ultrasound is a well‐established imaging modality for assessing laryngeal structures and masses. The application of ultrasound to image‐guided biopsy of base of tongue, hypopharynx, thyroid nodules, and cervical lymph node metastases has been well documented, and its use in laryngeal cancer has been increasing in recent years 1‐4 . Ultrasound‐guided biopsy has high sensitivity and specificity, which are replicated through this technique to target laryngeal masses 1 .…”

“…In patients with more advanced tumors, tracheostomy may be necessary to secure the airway to safely perform DLB and obtain tissue. The use of in‐office transcervical ultrasound (TCUS)–guided fine‐needle aspiration (FNA) is well established for thyroid nodules, base of tongue lesions, and cervical lymph node metastases, and its use for diagnosis of laryngeal cancer has increased in recent years 1‐4 . We present a technique for in‐office transcervical FNA of N0 laryngeal masses using ultrasound guidance.…”