Volume : VI, Issue : V, May - 2017

METASTATIC LYMPH NODES IN THE NECK: DIAGNOSTIC ACCURACY OF CLINICAL VS ULTRASOUND EXAMINATION.

Praveen N, Deepa C. K, Swathilal S. A, Lakshmanan P. P

Abstract :

 The presence or absence of metastatic disease in the neck is the single most important factor determining the survival of patients with head and neck malignancy. The present study conducted in the department of Surgery, Medical College,  Kozhikkode during 2007 to 2010 is an attempt to determine the sensitivity and specificity of clinical examination of neck metastasis and the justification of selective neck dissection. A total of thirty nine patient admitted in various wards of department of surgery and radiotherapy with clinically palpable nodes in the cervical region with primary head and neck malignancies or with a diagnosis of occult metastasis in the neck. Compå the clinical and histological extent of metastasis, the sensitivity and specificity of clinical examination and the false positivity and false negativity rates of clinical neck examination were determined. All data were analyzed with GraphPad Instat 3 and R statistical environment Of the thirty nine patients enrolled into this study, there were 26(66.7%) males and 13(33.33%) females. Among the clinically positive group, thirty(91%) had unilateral cervical metastasis, while three(9%) had bilateral cervical metastasis. The most common lymph node level affected was level Ibo(51.2%) followed by II (34.9%) whereas the least commonly affected were level IV and V(2.3%). In 10 (30.3%) out of the thirty three node positive cases, there was fixity to the deeper structures, whereas skin involvement was present in only three cases(9.1%). Our study results showed that clinical examination had a better sensitivity and ultrasonically examination had better specificity. Presence of nodes can be identified with clinical examination alone though it could result in increased number of false positives. However further investigation like ultrasound examination  with better specificity and negative likelihood ratio in combination with clinical examination finding can direct the further management of the patients. 

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

PRAVEEN N, DEEPA C.K, SWATHILAL S.A, LAKSHMANAN P. P, METASTATIC LYMPH NODES IN THE NECK: DIAGNOSTIC ACCURACY OF CLINICAL VS ULTRASOUND EXAMINATION., INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : VOLUME-6 | Issue‾5 | May‾2017

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