Ultrasound versus physical examination in staging carcinoma of the mobile tongue

Abstract

Surgical therapy for early lesions of the tongue should have the potential to be both oncologically sound and easy to rehabilitate. Obviously, the amount of tongue left behind after surgery is proportional to the post-operative function. Hence accurate mapping of the diseased tongue is of paramount importance in order to limit or extend the resection margins. We have evaluated the use of ultrasound in carcinoma of the tongue, and also compared its relative accuracy with physical examination for determining the extent of growth, keeping the histopathological size as a gold standard. We found that ultrasound is more accurate in detecting T2 and T3 tumours than T1 lesions. Intraoral sonographic mappng may be the answer for such small lesions. In addition, ultrasonography is beneficial in showing spread to contiguous areas of the tongue. However, post-radiation fibrosis and frank residual disease were not differentiated accurately by ultrasound. Thus ultrasonography can be an effective investigative tool and together with physical examination it can increase diagnostic accuracy leading to precise surgery for carcinoma of the tongue.

Intraoral ultrasonography of tongue mass lesions

“…Physical examination of the tongue is considered easy because it is easily accessible by palpation. 4 In our study, only 52 (19.4%) cases among 268 cases received imaging examination before surgeries. CT and MRI are sometimes restricted owing to the metal artefacts from dental alloys.…”

Squamous Cell Carcinoma of the Head and Neck in Ontario, Canada, and in Southeastern Norway

“…The authors created 60 "tumors" in a series of 15 rabbits and found 19% falsepositive results, 32% false-negative results, no difference in accuracy between a preclinical medical student and a consultant, and a tendency to underestimate size. Narayana et al 20 reported similar findings (poor accuracy and underestimation of size) in a study that compared clinical examination of tongue cancer with ultrasound. These four studies from the head and neck literature have similar conclusions (poor inter-rater reliability, poor intrarater reliability, no difference with experience, and underestimation of size) to other studies on the reliability of clinical examination in gynecology, 21,22 urology, 23 orthopedic surgery, 24 and rheumatology.…”

Ultrasonography: A Noninvasive Tool to Diagnose a Caliber-Persistent Labial Artery, an Enlarged Artery of the Lip

“…[13][14][15][16] Palatal tumors and tongue and floor of the mouth carcinoma are investigated with intraoral ultrasonography before and during surgery, with evaluation of the tumor extension. [17][18][19][20] Currently, practitioners use clinical and histopathologic examination to diagnose a caliber-persistent labial artery (CPLA). We illustrate the use of ultrasonography as a noninvasive diagnostic tool to visualize this abnormal artery.…”