The sonography in the primary staging of head and neck tumors

The radiologic imaging methods play an important role in the precise staging as basic requirement for an effective concept of tumor therapy. The accuracy of ultrasound in the primary staging according to the TNM-classification (UICC) was therefore prospectively investigated in 260 patients with head and neck tumors of the clinical stages T1NO to T4N3. The clinically (C1) and sonographically (C2) evaluated pretherapeutic stages were compared to the postoperative histopathologic tumor classifications. The clinical staging was correct in 75.0%, high in %, low in 17.3%, the N-stages were correct in 59.2%, high in 17.7%, low in 23.1%. The sonographic staging was apparently superior with the T-classifications correct in 92.3%, high in 7.7%, low 0.0%. The N-stages were correct in 89.6%, high in 9.2%, low in 1.2%. The accuracy of combined TN classification rose from clinical 46.5% to 84.6% by sonography. Accompanying inflammations, foregoing biopsies and tooth extractions were the main reasons for incorrect staging. Therefore, the thorough sonographic investigation performed after the clinical examination and before invasive procedures, due to little patient discomfort, good availability and high accuracy, is an excellent sectional imaging method for staging, therapy-planning and follow up of tumors of the head and neck especially of the orofacial regions.