Narayana H M, Panda N K, Mann S B, Katariya S, Vasishta R K
Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Laryngol Otol. 1996 Jan;110(1):43-7. doi: 10.1017/s0022215100132682.
Surgical therapy for early lesions of the tongue should have the potential to be both oncologically sound and easy to rehabilitate. Obviously, the amount of tongue left behind after surgery is proportional to the post-operative function. Hence accurate mapping of the diseased tongue is of paramount importance in order to limit or extend the resection margins. We have evaluated the use of ultrasound in carcinoma of the tongue, and also compared its relative accuracy with physical examination for determining the extent of growth, keeping the histopathological size as a gold standard. We found that ultrasound is more accurate in detecting T2 and T3 tumours than T1 lesions. Intraoral sonographic mapping may be the answer for such small lesions. In addition, ultrasonography is beneficial in showing spread to contiguous areas of the tongue. However, post-radiation fibrosis and frank residual disease were not differentiated accurately by ultrasound. Thus ultrasonography can be an effective investigative tool and together with physical examination it can increase diagnostic accuracy leading to precise surgery for carcinoma of the tongue.
舌部早期病变的手术治疗应具备肿瘤学安全性和易于修复的潜力。显然，术后保留的舌体量与术后功能成正比。因此，准确描绘病变舌部对于限制或扩大切除边缘至关重要。我们评估了超声在舌癌中的应用，并将其在确定肿瘤生长范围方面的相对准确性与体格检查进行了比较，将组织病理学大小作为金标准。我们发现，超声检测T2和T3肿瘤比T1病变更准确。对于此类小病变，口腔内超声描绘可能是解决办法。此外，超声检查有助于显示舌部相邻区域的扩散情况。然而，超声无法准确区分放疗后纤维化和明显的残留疾病。因此，超声检查可以成为一种有效的检查工具，与体格检查相结合可提高诊断准确性，从而为舌癌实施精确手术。
