ABSTRACT
PURPOSE: The oral cavity is the most common site for squamous cell carcinoma, which has a distinct predilection for lymphatic spread before distant systemic metastasis. The cervical lymph node status is a very important consideration in the assessment of squamous cell carcinoma. Ultrasound is a noninvasive and inexpensive technique that can be used to differentiate between the benign and metastatic nodes. So the aim of this study was to evaluate reliability of ultrasound for such differentiation and to correlate them with histopathological finding. MATERIALS AND METHODS: A total of 200 lymph nodes from 38 patients histopathologically proven for oral squamous cell carcinoma who underwent surgical neck dissection were considered. The patients underwent ultrasound examination of cervical lymph nodes prior to surgical neck dissection. The lymph nodes were differentiated into benign and metastatic based on the assessment of size, shape, shortest diameter/longest diameter (S/L ratio), margin, and internal architecture, and also the internal echo structure of the lymph nodes and histopathological findings were analyzed. RESULTS: On correlation of ultrasonographic diagnosis with histopathological evaluation for metastatic lymph nodes, the overall accuracy of ultrasonographic analyses was 77.83%, and the sonographic criterion of irregular margin showed the highest predictability followed by the size. The correlation of internal echo structure with histopathological findings was highly variable. CONCLUSION: The ultrasound parameters such as size, shape, margin, S/L ratio, and internal echo structure might assist in differentiation between benign and metastatic lymph nodes. Combining these findings should raise the accuracy, as each sonographic parameter has some limitation as a sole criterion.
ABSTRACT
BACKGROUND AND PURPOSE: To assess the anterior (aAL) and caudal (cAL) extensions of Anterior loop (AL) of Inferior alveolar nerve (IAN) using Digital Panoramic (DP) and Cone Beam Computed Tomography (CBCT) for its presence and dimensions in various age groups, genders, right and left sides of the mandible and between dentulous and edentulous patients. METHODS: A 1-year retrospective comparative study between DP and CBCT to assess the extensions of AL of IAN was conducted on individuals referred to a private imaging center located in Bengaluru, South India. 360 mandibular sites were examined using DP and CBCT to assess the presence and dimensions of AL. RESULTS: Results showed higher frequency of AL in CBCT compared to DP. Also there was a decreasing frequency of AL with increasing age and an insignificant difference in frequency between males and females. Bilateral looping was most common, aAL was more frequent on the left side and cAL on the right of the mandible. Statistically higher frequency in dentate group compared to edentulous. A decreasing mean value with increasing age and higher mean values in CBCT than DP. No significant difference in mean values among males and females or between the dentulous and edentulous groups. Higher mean values in CBCT compared to DP on the left side of the mandible compared to the right. CONCLUSION: Choosing mental foramen as reference for termination of IAN could result in injury to AL; low sensitivity and specificity of DP compared to CBCT in assessing frequency and extent of AL underlines its inadequacy, while CBCT can be performed with comparable resolution, to accurately analyze AL.
