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Warm JJ, Melchiors J, Kristensen TT, Aabenhus K, Charabi BW, Eberhard K, Konge L, von Buchwald C, Todsen T. Head and neck ultrasound training improves the diagnostic performance of otolaryngology residents. Laryngoscope Investig Otolaryngol 2024; 9:e1201. [PMID: 38362178 PMCID: PMC10866603 DOI: 10.1002/lio2.1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/01/2023] [Accepted: 11/26/2023] [Indexed: 02/17/2024] Open
Abstract
Objective Surgeon-performed head and neck ultrasound (US) is increasingly used among otolaryngologists in office-based and surgical settings. However, it is unknown how formal US training affects otolaryngology residents' diagnostic workup of patients with cervical pathology. This study examined how a formal US course for residents affected their outpatient clinic US performance and diagnostic accuracy. Methods We conducted a randomized cross-over trial, where 13 otolaryngology residents participated in a 6-h formal US course. Participants were randomized to perform head and neck US on four patient cases before and after completing the course. Eight patients with and without neck pathology were invited to participate as test cases. The ultrasound examinations were video recorded and anonymized before two consultants rated the US performance using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. Otolaryngology residents wrote an ultrasound report with a diagnosis based on their US examination, which was used to calculate the specificity and sensitivity. Results We found a statistically significant difference in the OSAUS score before compared to after the hands-on training (p = .035). The diagnostic accuracy also increased from 62% before the course to 75% after the course (p = .02). Specificity increased from 54% prior to the course to 62% following the course, and sensitivity increased from 64% prior to the course to 79% following the course. The intraclass correlation coefficient with "absolute agreement" was 0.63. Conclusion This study demonstrates that short, formal ultrasound training can improve otolaryngology residents' ultrasound skills and diagnostic accuracy in an outpatient clinic setting. Lay summary This study looks at the change of otolaryngology residents' diagnostic workup of patients after they take a formal ultrasound course and shows that they get better at using ultrasound and make more accurate diagnoses if they take a formal course. Level of Evidence Level 2.
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Affiliation(s)
- Jens Jessen Warm
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
| | - Jacob Melchiors
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Tina Toft Kristensen
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
| | - Kristine Aabenhus
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
| | - Birgitte Wittenborg Charabi
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Kristine Eberhard
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
| | - Lars Konge
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Copenhagen Academy for Medical Education and SimulationUniversity of Copenhagen and the Capital Region of DenmarkCopenhagenDenmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Tobias Todsen
- Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyCopenhagen University HospitalCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Copenhagen Academy for Medical Education and SimulationUniversity of Copenhagen and the Capital Region of DenmarkCopenhagenDenmark
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Pillong L, Bozzato A, Hecker D, Bozzato V, Schick B, Kulas P. “A Head Start or a Pain in the Neck?”—Establishment and Evaluation of a Video-Based “Hands-On” Head and Neck Ultrasound Course. Diagnostics (Basel) 2022; 12:diagnostics12051239. [PMID: 35626394 PMCID: PMC9141540 DOI: 10.3390/diagnostics12051239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.
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Kshirsagar RS, Anderson M, Boeckermann LM, Gilde J, Shen JY, Meltzer C, Wang KH. The Adult Neck Mass: Predictors of Malignancy. Otolaryngol Head Neck Surg 2021; 165:673-681. [PMID: 33687292 DOI: 10.1177/0194599821996293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Distinguishing benign from malignant adult neck masses can be challenging because data to guide risk assessment are lacking. We examined patients with neck masses from an integrated health system to identify patient and mass factors associated with malignancy. STUDY DESIGN Retrospective cohort. SETTING Kaiser Permanente Northern California. METHODS The medical records of adults referred to otolaryngology in 2017 for a neck mass were evaluated. Bivariate and multivariable logistic regression analyses were performed. RESULTS Malignancy was found in 205 (5.0%) of the cohort's 4103 patients. Patient factors associated with malignancy included sex, age, and race/ethnicity. Males had more than twice the odds of malignancy compared with females (adjusted odds ratio [aOR] = 2.38). Malignancy rates increased with age, ranging from 2.1% for patients younger than 40 years to 8.4% for patients 70 years or older. White non-Hispanic patients had 1.75 times the risk of malignancy compared with patients of other race/ethnicities. The percentage of patients with malignancy increased with increasing minimum mass dimension, from 3.0% in patients with mass size <1 cm to over 31% in patients with mass sizes 2 cm or larger (P < .0001). Imaging-based mass factors most highly predictive of malignancy included larger minimum mass dimension (≥1.5 cm vs <1.5 cm: aOR = 3.87), multiple masses (2 or more vs 1: aOR = 5.07), and heterogeneous/ill-defined quality (aOR = 2.57). CONCLUSION Most neck masses referred to otolaryngology were not malignant. Increasing age, male sex, white non-Hispanic ethnicity, increasing minimum mass dimension, multiple neck masses, or heterogeneous architecture/ill-defined borders were associated with malignancy.
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Affiliation(s)
- Rijul S Kshirsagar
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Oakland, Oakland, California, USA
| | | | - Lauren M Boeckermann
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Oakland, Oakland, California, USA
| | - Jason Gilde
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Oakland, Oakland, California, USA
| | - Joseph Y Shen
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Oakland, Oakland, California, USA
| | - Charles Meltzer
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Santa Rosa, Santa Rosa, California, USA
| | - Kevin H Wang
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center Oakland, Oakland, California, USA
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Straughan AJ, Badger CD, Benito DA, Joshi AS. Salivary gland ultrasound training: Improving anatomic identification in residents. Am J Otolaryngol 2020; 41:102734. [PMID: 33198050 DOI: 10.1016/j.amjoto.2020.102734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of the study was to introduce and study the role of standardized views for ultrasound of the major salivary glands in resident learning and retention. STUDY DESIGN Methods description and prospective case series. METHODS Five otolaryngology residents and two patient models were recruited for this study. The participants were timed on their identification of the submandibular gland, sublingual gland, and parotid gland and associated key anatomic structures. Participants were then timed again immediately after being presented a standardized view for each salivary gland: the longitudinal submandibular gland, transverse parotid gland, and submental transverse views. The same participants were then timed one month later to determine retention. A Wilcoxon signed-rank test was used to evaluate whether time to identification was equal pre- and post-standardized view instruction. RESULTS There was a significant improvement from pre- to post-standardized view instruction in all glands, which was sustained one month later. Practically speaking, assessment times for all participants at the one-month measurement were reasonable, with averages of 71, 42, and 114 s for the submandibular gland, sublingual gland, and parotid gland respectively. CONCLUSIONS Standardized views provided otolaryngology ultrasonography learners with a reliable, fast, and memorable way to assess the salivary glands and their related structures. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Alexander J Straughan
- The George Washington University, Division of Otolaryngology, Head and Neck Surgery, Washington, DC, United States of America
| | - Christopher D Badger
- The George Washington University, Division of Otolaryngology, Head and Neck Surgery, Washington, DC, United States of America.
| | - Daniel A Benito
- The George Washington University, Division of Otolaryngology, Head and Neck Surgery, Washington, DC, United States of America
| | - Arjun S Joshi
- The George Washington University, Division of Otolaryngology, Head and Neck Surgery, Washington, DC, United States of America
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Meister KD, Vila PM, Bonilla-Velez J, Sebelik M, Orloff LA. Current Experience of Ultrasound Training in Otolaryngology Residency Programs. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:393-397. [PMID: 30099758 DOI: 10.1002/jum.14700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/27/2018] [Accepted: 05/02/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The applications of using ultrasound for the evaluation and management of otolaryngologic diagnoses are expanding. The purpose of this study was to evaluate the current experience of ultrasound training in otolaryngology residency programs. METHODS All allopathic and osteopathic otolaryngology residency programs in the United States were surveyed online via an e-mailed survey link to the resident representatives of the Section for Residents and Fellows in Training of the American Academy of Otolaryngology-Head and Neck Surgery. We present a descriptive analysis of the survey results. RESULTS A total of 110 responses were obtained from resident representatives at MD and DO otolaryngology residency programs, representing a response rate of 94.8%. Forty-four percent of residents reported that they would not feel comfortable with performing ultrasound-guided procedures after residency; 43% reported that they do not perform ultrasound procedures as a part of their residency training; and 60% of those trainees performing ultrasound procedures do not log the procedures. Twenty-three percent of residents did not have access to an ultrasound machine. Most respondents (71%) desired more exposure to diagnostic and/or interventional ultrasound training during residency. CONCLUSIONS Although current experience is variable, there is a strong interest in increasing resident skill acquisition in ultrasound training among otolaryngology residents. Some barriers to these goals may be a lack of trained faculty members using ultrasound and insufficient recording mechanisms for residents performing ultrasound procedures.
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Affiliation(s)
- Kara D Meister
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Peter M Vila
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Juliana Bonilla-Velez
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Merry Sebelik
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
| | - Lisa A Orloff
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA
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Anatomic factors affecting the use of ultrasound to predict vocal fold motion: A pilot study. Am J Otolaryngol 2018; 39:413-417. [PMID: 29678501 DOI: 10.1016/j.amjoto.2018.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/04/2018] [Accepted: 04/09/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Ultrasonography is a well-established modality for visualization of head and neck anatomy. Using ultrasound to detect vocal fold mobility has been described before, but no study has evaluated factors affecting the exam reliability. The aim of the study is to determine anatomic factors influencing the reliability of ultrasound to detect vocal fold motion. Methods and materials Patients underwent ultrasound evaluation and flexible laryngoscopy to assess vocal fold motion from August 2015 to March 2016. Length, accuracy, and clarity of ultrasound examination were assessed, compared to flexible laryngoscopy. For patients with prior neck CT scan imaging, laryngeal anatomy was independently assessed by a blinded neuroradiologist. RESULTS A total of 23 patients, 21 with bilateral vocal fold motion and two with unilateral paralysis, were enrolled. Vocal folds were visible in 19 patients (82%). Eight patients (42%) had good/excellent view and 11 patients (58%) had fair/difficult view. The ultrasound correctly detected absent movement of the vocal fold in the two patients with unilateral paralysis. A total of 19 patients had CT scans, and a linear correlation (r2 = 0.65) was noted between the anterior thyroid cartilage angle measured on CT and the grade of view on ultrasound. CONCLUSION Ultrasound was able to detect vocal fold motion in 82% of randomly screened patients. Ease of detection of vocal fold motion correlated with the anterior thyroid angle. Further studies are warranted to investigate the reproducibility of our results and how this might impact use of ultrasound for detection of vocal fold motion in the operative setting.
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Haidar YM, Moshtaghi O, Mahmoodi A, Helmy M, Goddard JA, Armstrong WB. The Utility of In-Office Ultrasound in the Diagnosis of Parotid Lesions. Otolaryngol Head Neck Surg 2017; 156:511-517. [DOI: 10.1177/0194599816687744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To determine whether the use of in-office ultrasound (US) by a head and neck surgeon is a useful adjunct to clinical assessment of parotid lesions and decrease the need of additional imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT). Study Design Case series with chart review. Setting Tertiary care academic center. Subjects Seventy patients presenting with a parotid lesion who obtained an in-office US and ultrasound-guided fine-needle aspiration (USGFNA) from a head and neck surgeon from 2006 to 2015. Methods US images were retrospectively reviewed for 70 patients and characterized by a radiologist and a head and neck surgeon. Results Of the 70 patients, 6 had US characteristics that demonstrated a statistically significant association with a benign/malignant diagnosis: depth from surface; irregular borders; presence of calcifications, which included either micro- or macro-calcifications; posterior echogenicity enhancement; irregular shape; and homogeneous/heterogeneous echotexture. Imaging was performed prior to referral in 25 cases (35.7%); of those, 17 (68%) were for superficial, small (<2 cm) tumors where prereferral imaging studies did not provide additional information to that obtained with US. Of the 55 patients without MRI or CT performed prior to referral, MRI or positron emission tomography–CT scan was obtained in only 4 patients (7.3%) in cases involving recurrent parotid lesions, large tumors, or workup of a malignant neoplasm. Conclusions Several US characteristics individually assist in lesion characterization. In-office US and USGFNA are an appropriate first-line modality in the assessment of parotid lesions, can allow for immediate parotid lesion assessment, and can decrease the need for additional imaging.
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Affiliation(s)
- Yarah M. Haidar
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA
| | | | - Amin Mahmoodi
- Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Mohammad Helmy
- Department of Radiology, University of California, Irvine Medical Center, Irvine, California, USA
| | - Julie A. Goddard
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - William B. Armstrong
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA
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Stenner M, Koopmann M, Rudack C. Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations. Eur Arch Otorhinolaryngol 2016; 274:855-860. [PMID: 27628964 DOI: 10.1007/s00405-016-4296-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode. All pictures were quantitatively evaluated by measuring 13 lengths and 4 ratios. All patients underwent a rhinomanometry measuring the nasal air flow. Besides others, men as well as older patients have a significantly thicker alar cartilage. Patients with thinner alar cartilages have a significantly smaller interdomal distance as well as significantly thinner upper lateral cartilages. The soft tissue above the bony dorsum was significantly thicker in older patients. Younger patients have significantly thicker soft tissue in relation to their cartilage. Patients with thicker soft tissue and thinner cartilage have a smaller tip. The interdomal distance and the thickness of the cartilaginous septum significantly correlated with the nasal air flow. We set up standard values of nasal structures in septorhinoplasty patients which can be used as reference values. By judging cartilage and soft tissue characteristics preoperatively, relevant factors for distinct procedures could be analyzed and the surgical steps can be better planned. Visualization by ultrasonography enables the surgeon to achieve treatment goals in a more predictable fashion.
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Affiliation(s)
- Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany.
| | - Mario Koopmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany
| | - Claudia Rudack
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany
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[Interpretation of ultrasound findings in otorhinolaryngology : Skin, soft tissue of the neck, lymph nodes, and oncologic follow-up]. HNO 2015; 63:139-54. [PMID: 25515129 DOI: 10.1007/s00106-014-2961-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A major advantage of head and neck sonography over other imaging methods is that the attending physician performs the examination himself/herself and can directly compare the imaging findings with other clinical and endoscopic findings. Given the "big picture," the physician is thus able to interpret the sonographic findings correctly. The first part of this article gives an exemplary overview of lesions of the skin, neck, and lymph nodes as well as the ensuing oncologic follow-up with ultrasound. In the second part the focus lies on salivary glands, paragangliomas, the esophagus, and vascular pathologies.
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Bernard S, Richardson C, Hamann CR, Lee S, Dinh VA. Head and Neck Ultrasound Education-A Multimodal Educational Approach in the Predoctoral Setting: A Pilot Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015. [PMID: 26206830 DOI: 10.7863/ultra.34.8.1437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVES With the increased implementation of ultrasound in medical education, it is important to continually improve instructional methods. In this study, we demonstrate that by augmenting the traditional methods of instructor demonstration and student practice on a healthy volunteer with additional modalities, such as didactic presentation, simulated pathologic cases, and simulated procedures, students gain a more comprehensive understanding of and confidence in ultrasound technique and pathology. METHODS A multimodal curriculum was developed and applied to head and neck ultrasound sessions of our institution's Ultrasound Symposium. Participants were asked to fill out surveys rating each instructional modality as well as preinstructional and postinstructional confidence. The survey results were divided into a group of first- and second-year medical students who had previous ultrasound training and a group of third- and fourth-year students who were ultrasound "naïve." RESULTS The survey showed that the first- and second-year student group (n = 8) had an average preinstructional confidence of 4.14/10 compared to 1.44/10 in the third- and fourth-year student group (n = 9) (P = .003). Following the instructional sessions, the students' confidence increased respectively to 8.14/10 and 7.78/10 (P= .53), showing a 4.00 (96%) increase in the first- and second-year group and a 6.34 (440%) increase in the third- and fourth-year group. The combined results of all student teaching modality ratings showed that instructor demonstration was rated the highest (9.47) and computerized simulation lowest (8.25). CONCLUSIONS Overall, our study shows that multimodal ultrasound instruction was beneficial in increasing both ultrasound-trained and ultrasound-naïve medical students' confidence in head and neck ultrasound.
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Affiliation(s)
- Stewart Bernard
- Loma Linda University School of Medicine, Loma Linda, California USA (S.B., C.R., C.R.H.); and Departments of Otolaryngology-Head and Neck Surgery (S.L.), Emergency Medicine (V.A.D.), and Medicine, Division of Critical Care (V.A.D.), Loma Linda University, Loma Linda, California USA.
| | - Clare Richardson
- Loma Linda University School of Medicine, Loma Linda, California USA (S.B., C.R., C.R.H.); and Departments of Otolaryngology-Head and Neck Surgery (S.L.), Emergency Medicine (V.A.D.), and Medicine, Division of Critical Care (V.A.D.), Loma Linda University, Loma Linda, California USA
| | - Carsten R Hamann
- Loma Linda University School of Medicine, Loma Linda, California USA (S.B., C.R., C.R.H.); and Departments of Otolaryngology-Head and Neck Surgery (S.L.), Emergency Medicine (V.A.D.), and Medicine, Division of Critical Care (V.A.D.), Loma Linda University, Loma Linda, California USA
| | - Steve Lee
- Loma Linda University School of Medicine, Loma Linda, California USA (S.B., C.R., C.R.H.); and Departments of Otolaryngology-Head and Neck Surgery (S.L.), Emergency Medicine (V.A.D.), and Medicine, Division of Critical Care (V.A.D.), Loma Linda University, Loma Linda, California USA
| | - Vi Am Dinh
- Loma Linda University School of Medicine, Loma Linda, California USA (S.B., C.R., C.R.H.); and Departments of Otolaryngology-Head and Neck Surgery (S.L.), Emergency Medicine (V.A.D.), and Medicine, Division of Critical Care (V.A.D.), Loma Linda University, Loma Linda, California USA
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Martins FL, Salum FG, Cherubini K, de Figueiredo MAZ. Utility of ultrasonography as an auxiliary method in the diagnosis of lesions in oral soft tissues. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Stenner M, Rudack C. Ultrasound imaging of the nose in septorhinoplasty patients. Eur Arch Otorhinolaryngol 2014; 272:2831-7. [PMID: 25362558 DOI: 10.1007/s00405-014-3381-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 10/28/2014] [Indexed: 11/30/2022]
Abstract
Detailed preoperative planning based on available clinical information is an essential component of determining septorhinoplasty outcome. In addition to rhinoscopy and airway measurements, preoperative photographs are the only image modalities that are regularly used in septorhinoplasty patients and contribute to the preoperative planning of the surgery. The aim of this study was to evaluate the use of high-resolution ultrasonography in septorhinoplasty patients before surgery and during follow-up. We examined 35 patients before and after open septorhinoplasty using 12- and 15-MHz B-mode, linear array transducer ultrasound in noncontact mode. The patients presented with a variety of different functional and aesthetic problems, and all underwent septorhinoplasty for septal modification, and tip and dorsum refinement. The mean follow-up time for ultrasound after surgery was 4.5 weeks. Soft tissue, cartilaginous, and bony structures of the nose could be well-visualised. In the untreated nose, functional and aesthetic characteristics as well as preoperative anatomy relevant for the planning of the surgery could be documented. Surgical modifications of the treated nose postoperatively, that is, osteotomies, inserted spreader grafts, diced cartilage in fascia, and tip sutures could be visualized and followed. Ultrasonography of the nose with a high-frequency transducer may be a helpful tool during preoperative planning and postoperative follow-up in septorhinoplasty patients and might be a reasonable completion to the common photographic and functional diagnostic.
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Affiliation(s)
- Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany,
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13
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Martins FL, Salum FG, Cherubini K, Oliveira R, de Figueiredo MAZ. Contribution of Ultrasonography to the Diagnosis of Submucosal and Subcutaneous Nodular Lesions of the Oral and Maxillofacial Region: Analysis of Cases. J Maxillofac Oral Surg 2014. [PMID: 26225066 DOI: 10.1007/s12663-014-0714-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the contribution of ultrasonography in the establishment of the diagnosis of nonspecific nodular lesions of the oral soft tissues. We determined the indication of use and reliability of ultrasonography in the field of dentistry, considering whether it was of value in the conclusive diagnosis of these pathologies. MATERIALS AND METHODS We recruited 65 patients from the Oral Medicine Unit of São Lucas Hospital, who had submucosal and subcutaneous nodules, without established diagnosis. They were subjected to ultrasonography of the lesion, carried out with standardization of the protocol and equipment, utilizing a Doppler system. The ultrasonographic report was prepared by an experienced professional, noting the imaging characteristics as well as the possibility of diagnosis. Two calibrated examiners analyzed the data, comparing the ultrasonographic report with the final diagnosis. Accordingly, we used established scoring, where zero corresponded to no contribution to the final diagnosis, 1 helped in the management of the case, and 2 when imaging determined the diagnosis. RESULTS A zero score was obtained for 12.3 % of the examinations performed, and 1 and 2 accounted for respectively 41.5 and 46.1 %, totaling a contribution of about 88 %. Ultrasonography was of value in the diagnosis of vascular lesions in 93.3 % and of neoplasms in 87.5 %. In the salivary gland diseases, it contributed to the final diagnosis in 75 %. CONCLUSION The results demonstrated that ultrasonography is an effective tool in the determination of the definitive diagnosis of nonspecific nodular lesions of the soft tissues of the oral and maxillofacial region.
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Affiliation(s)
- Felipe Leal Martins
- Oral Medicine Unit, São Lucas Hospital, Dentistry School, Pontifical Catholic University of Rio Grande do Sul (PUCRS), 6690 Ipiranga avenue - 2nd floor/room 231, Porto Alegre, RS CEP 90610-000 Brazil
| | - Fernanda Gonçalves Salum
- Oral Medicine Unit, São Lucas Hospital, Dentistry School, Pontifical Catholic University of Rio Grande do Sul (PUCRS), 6690 Ipiranga avenue - 2nd floor/room 231, Porto Alegre, RS CEP 90610-000 Brazil
| | - Karen Cherubini
- Oral Medicine Unit, São Lucas Hospital, Dentistry School, Pontifical Catholic University of Rio Grande do Sul (PUCRS), 6690 Ipiranga avenue - 2nd floor/room 231, Porto Alegre, RS CEP 90610-000 Brazil
| | - Roberto Oliveira
- Brazilian College of Radiology, São Paulo, Brazil ; Clinical Radiology Unit, Radiology and Ecography Foundation of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- Oral Medicine Unit, São Lucas Hospital, Dentistry School, Pontifical Catholic University of Rio Grande do Sul (PUCRS), 6690 Ipiranga avenue - 2nd floor/room 231, Porto Alegre, RS CEP 90610-000 Brazil ; Serviço de Estomatologia do Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690 - 2º andar/sala 231, Porto Alegre, RS CEP 90610-000 Brazil
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