Preoperative evaluation of cervical lymph nodes for metastasis in patients with oral squamous cell carcinoma: A comparative study of efficacy of palpation, ultrasonography and computed tomography

INTRODUCTION: Oral cancer is a major health threat in a country like India, where patients frequently present with advanced disease with regional dissemination to cervical lymph nodes. The management and prognosis depend on the status of cervical lymph nodes. Thus, it becomes imperative to diagnose and evaluate them preoperatively. AIM: This study aims to compare the efficacy of palpation, ultrasonography (USG) and computed tomography (CT) in the preoperative evaluation of cervical lymph node for metastasis in patients with oral squamous cell carcinoma. SETTINGS: Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India. METHODOLOGY: A total of thirty patients of either sex of age group 20–70 years, diagnosed with oral cancer were randomly selected for the study and subjected to palpation, USG and computer tomography followed by histopathology for confirmation. The results were evaluate statistically by sensitivity, specificity, positive predictive value, and negative predictive value and accuracy. RESULTS: For level IA palpation, USG and CT were equally sensitive (100%) and specific (100%). Although palpation, USG and CT were equally sensitive (80%) for level IB, the specificity of palpation (70%) <USG (95%) = CT (95%). For level II sensitivity of palpation (25%) <USG (75%) <CT (100%) whereas specificity was CT (84.6%) <palpation (92.3%) <USG (100%). CONCLUSION: CT (96.1%) and USG (97.7%) were more accurate than palpation (92.7%), for detection of metastasis in cervical lymph nodes in patients with oral squamous cell carcinoma. CT along with USG should be used for accurate preoperative evaluation of cervical lymph node.