Ultrasound-guided fine-needle aspiration cytology as a diagnostic tool in comparison to ultrasound and MRI for staging in oral- and oropharyngeal squamous cell tumors.

The aim of this retrospective study was to test the diagnostic performance of ultrasound guided fine-needle aspiration cytology (USFNAC) in comparison to ultrasound (US) and magnetic resonance imaging (MRI) for detecting lymph node metastases in patients with squamous cell carcinoma of the oral and oropharyngeal region. 143 patients with oral cavity and oropharyngeal squamous cell carcinoma were included in the study. US, USFNAC and MRI were routinely performed prior to neck dissection. The results of the imaging studies were compared to histopathology. The sensitivity of MRI was highest at 83%, followed by USFNAC and US at 81% and 73%, respectively. The specificity was highest for FNAC at 100%, followed by MRI and US at 76% and 45%, respectively. Positive predictive value was highest for USFNAC 100%, US 57%, MRI 75% and negative predictive value was 77%, 69% and 84%, respectively. In our patient group with oral and oropharyngeal carcinoma, MRI had a higher sensitivity than USFNAC and US alone. USFNAC provided additional staging information. Especially in an uncertain lymph node situation it can facilitate and optimize preoperative planning with a specificity of 100% regarding tissue entity of cervical lymph nodes.

Long-term survival of dental implants placed in the grafted maxillary sinus: systematic review and meta-analysis of treatment modalities.

BACKGROUND: A prevalent modality to increase the amount of available bone prior to implantation is grafting of the maxillary sinus. Multiple factors such as the surgical technique, moment of implant placement as well as grafting materials and membranes are known to affect implant survival. However, the role of different factor combinations and associated reciprocal effects remain unclear. Conventional statistical methods do not consider inconsistency of study designs and do not take covariables into account. Hence, a systematic research and meta-analysis was conducted to investigate the influence of various treatment modalities on implant survival in the grafted maxillary sinus. MATERIALS AND METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Articles published from 1980 through January 2013 were electronically and manually searched in MEDLINE (Ovid), the Cochrane Register of Controlled Trials, the Database of Abstracts of Effects, and the Cochrane Database of Systematic Reviews. Clinical reports on single intervention sinus augmentation with root-form implants, a minimum of 10 patients and 6 months of loading were eligible for inclusion if implant survival was stated or calculable. Results were calculated by non-parametric univariate Kaplan-Meier analysis and Bayesian multivariate interval-censored Cox regression. RESULTS: A total of 122 publications on 16268 endosseous implants placed in grafted maxillary sinus were included. The treatment parameters surgical approach, grafting material and implant type showed no selective preference. However, application of membranes showed a significantly reduced hazard-ratio, independent of other co-factors. CONCLUSIONS: The use of membranes is the most significant factor to achieve long-term implant survival in sinus augmentation procedures. More data exceeding 3 years follow-up are needed to address prospective confounding and improve clinical evidence.