Novel Techniques in Head and Neck Ultrasound

Abstract

Objective: 1) Report new uses of ultrasound within the head and neck. 2) Emphasize how the use of ultrasound can enhance patient management and alter treatment delivery.

Method: Present a series of 7 cases from the past year at a single academic institution where ultrasound was used in a novel way to enhance patient care. Compare the ultrasound images obtained with other imaging modalities.

Results: Three patients underwent ultrasound-guided fine- needle aspiration (FNA) of tongue base tumors, which avoided the necessity of a tracheotomy in 1 patient with a difficult airway. Two patients underwent ultrasound-guided FNA of supraglottic tumors through the thyrohyoid membrane, which obviated the need for biopsy with general anesthesia. One noncancer patient had a highly metabolic enlarged lymph node on PET/CT though it demonstrated benign characteristics on ultrasound. Both ultrasound-guided FNA and incisional biopsy confirmed the lymph node’s benignity. One patient had a vallecular foreign body seen on ultrasound but not on flexible laryngoscopy, and it was retrieved in the operating room.

Conclusion: Ultrasound can be used to guide FNA for tissue diagnosis from tongue base and larynx tumors. Ultrasound-guided FNA may eliminate the need for biopsy under general anesthesia for some patients. Ultrasound has an expanding array of applications and is a useful tool in the otolaryngologist’s hands.