[Value of sonomorphologic criteria in the identification of regional metastases of squamous cell cancers of the ENT area].

We compared the preoperative ultrasound findings with the histological results of 127 neck dissections for squamous cell carcinoma of the head and neck. We checked several sonomorphological criteria (size, shape, boundary, echo structure, arrangement, mobility) to assess their value in identification of metastatic disease. If all nodes found on ultrasound were classed as metastases, the specificity was 30%, because many lymph nodes showed nonspecific reaction only. Lymph nodes with a rupture of the capsule or central necrosis or being larger than 3 cm, proved to be metastatic in all cases. Round or oval nodes with a size of more than 2 cm were found to be metastatic with an accuracy of 89%. The almost certain (97%) identification of necks with no metastatic lymph nodes allows elective neck dissection to be avoided.