[The relevance of sonographic diagnosis of cervical lymph nodes in tumors of the head and neck].

Thirty patients with a squamous cell carcinoma of the head and neck, with cervical lymph nodes which could be shown by ultrasound but not by palpation of the neck, are reviewed. The cervical lymphatic nodes, which were similar in size to the preoperative ultrasonic measurement, were removed by elective neck dissection. Histological examination showed a reactive inflammation only, without tumour infiltration, in 83.3% of the cases. These clinically inconspicious lymph nodes, which were homogeneous on ultrasound scan and could be easily differentiated from the background, obviously show the premalignant stage of tumour spread. The consequences for the operation and later follow-up are discussed.