The state of the art of ultrasonography in the head and neck.

When considering patient comfort, length of testing, availability, the increased diagnostic capabilities and relative cost, we believe that ultrasonography is an important addition to the diagnostic tests currently used in otolaryngology. It is a noninvasive method with high sensitivity. When one includes the techniques of ultrasound-guided fine-needle aspiration, cutting biopsy and colour-coded duplex sonography, the specificity is further augmented and is superbly suited for demonstrating, detecting and excluding pathologies in the head and neck region. It will increase the accuracy of preoperative staging of patients with head and neck squamous cell cancer. It is even possible that it may change the indications for therapeutic and elective neck treatment. In addition it is valuable during the follow-up of patients treated with radiation or/and chemotherapy. In many situations, ultrasonography is superior to CT or MRI because it is a dynamic imaging technique with the possibility of simultaneous palpation of the lesion. It does not force the surgeon to reconstruct anatomy from computer generated slices which leave gaps that may miss disease and it can detect major vessel invasion by tumour.