Novel use of ultrasound-guided surface marking of head and neck tumors invading facial skin

Treatment of buccal mucosal carcinomas: A survey amongst head and neck surgeons in the Netherlands

Objective

Currently, there is no up-to-date guideline for the treatment of buccal mucosal squamous cell carcinoma (BMSCC) in the Netherlands. A questionnaire was used to investigate the opinions of Dutch head and neck surgeons on BMSCC of the cheek treatment.

Methods

A questionnaire was sent to all 91 head and neck surgeons in the Netherlands. Their opinions on surgical tumor-free margins, through-and-through defects, and indications for local adjuvant therapy were questioned.

Results

The response rate was 51%. To prevent a through-and-through defect, 67% of the surgeons would accept a deep clinical (macroscopic) margin of ≤5 mm. The less adverse histological characteristics a tumor has, the less consensus there is amongst the surgeons for local adjuvant treatment in case of close margins.

Conclusion

There is no consensus amongst Dutch head and neck surgeons about the optimal treatment for BMSCC of the cheek. There are different opinions on acceptable resection margins, indications for a through-and-through defect, and indications for adjuvant treatment. BMSCC of the cheek treatment should be more uniform and less surgeon dependent.

Level of evidence

N/A.

Ultrasound backscatter microscopy for imaging of oral carcinoma

OBJECTIVES

Ultrasound backscatter microscopy (UBM), or ultrasound biomicroscopy, is a noninvasive, label-free, and ionizing radiation-free technique allowing high-resolution 3-dimensional structural imaging. The goal of this study was to evaluate UBM for resolving anatomic features associated with squamous cell carcinoma of the oral cavity.

METHODS

The study was conducted in a hamster buccal pouch model. A carcinogen was topically applied to cheeks of 14 golden Syrian hamsters. Six additional hamsters served as healthy controls. A high-frequency (41 MHz, 6-mm focal depth, lateral and axial resolutions of 65 and 37 μm, respectively) UBM system was used for scanning the oral cavity after 14 weeks of carcinogen application. Histologic analyses were conducted on scanned regions.

RESULTS

The histologic structure of buccal tissue and microvasculature networks could be visualized from the UBM images. Epithelial and mucosal hypertrophy and neoplastic changes were identified in animals subjected to the carcinogen. In animals with invasive squamous cell carcinoma, lesion development and destruction of the structural integrity of tissue layers were noted.

CONCLUSIONS

In this pilot study, UBM generated sufficient contrast for morphologic features associated with oral carcinoma compared to healthy tissue. This modality may present a practical technique for detection of oral neoplasms that is potentially translatable to humans.

Sound waves for unsound entities: an electronic search study to evaluate the diagnostic efficacy of ultrasonography in cysts and tumors of maxillofacial region

OBJECTIVE

The purpose of this electronic search study was to evaluate the diagnostic efficacy of ultrasonography in cysts and tumors of maxillofacial region.

MATERIALS AND METHODS

An electronic search was performed for articles published from January 1989 to august 2009.

RESULTS

Only 30 publications were searched and 22 publications showed high level of evidence (4 review articles, 12 clinical studies, 2 case reports, 1 quantitative analysis, 2 research articles and 1 preliminary report) with total of more than 2000 patients.

CONCLUSION

Ultrasonography is a noninvasive, low cost procedure, and recommended as a complimentary imaging modality.