Use of transoral ultrasonography technique in tongue cancer: Advantages and disadvantages

Abstract

Aim. To evaluate advantages and disadvantages of transoral ultrasonography (US) in tongue cancer.Materials and methods. US was performed in 165 patients between the ages of 15 and 85 years with malignant tumors of the mobile tongue (74 (44.9 %) women, 91 (55.1 %) men).Among 165 patients, 144 had primary tongue tumor. The study also included 21 (12.7 %) patients with recurrent tumor which clinically could be represented by a true recurrence (tumor development 6 months after the end of treatment) or by continued growth (tumor development less than 6 months after the end of treatment). The study included patients with tongue tumors Т1 - 50 (30.3 %) patients, Т2 - 78 (47.3 %) patients, Т3 - 16.4 % of patients, Т4 - 6.1 % of patients.Three types of approach to tongue tumor visualization were used: submandibular, transoral, and transbuccal with a standard linear transducer (4-9 MHz) and intraoperative linear transducer (5-14 MHz). In total in 165 patients with tongue tumors, 147 (89.1 %) transoral US, 86 (52.1 %) submandibular US and 25 (15.2 %) transbuccal US examinations were performed.Results. Among 165 patients, agreement between the sizes measured using US and histological examination was observed in 142 (86.1 %) patients taking into account 15 % error.With increasing tumor thickness and, correspondingly, T criterion, increased frequency of agreement between US data and histological data was observed. Thus, for T1 stage frequency of agreement with US data was observed in 61.8 % of cases, for Т2 stage in 81.1 % of cases, for Т3 stage in 93.8 %, and for Т4 stage agreement was observed in 100 % of cases.Frequency of agreement with histological data in evaluation of tongue tumor thickness for transoral approach was significantly higher than for submandibular approach (р = 0.014). Transoral technique was more accurate for measurement of thickness of primary tumors - 80.3 % of results agreed with histological examination, and for recurrences frequency of agreement was only 33.3 %. Submandibular approach for primary tumors showed accurate measurements only in 67.6 % of cases, in recurrent tumors in 58.3 % of cases. Transbuccal approach also showed higher measurement accuracy for tumor thickness in primary patients (70.0 %) compared to recurrent tumors (40.0 %).Conclusion. Use of transoral ultrasonography significantly improves clinical staging of tongue tumors at the preoperative stage.