Skip to main content

Advertisement

SpringerLink
Log in

Surgeon-performed ultrasound in a head and neck surgical oncology clinic: saving time and improving patient care

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

Surgeon-performed ultrasound (SUS) for head and neck masses is increasingly being performed by head and neck surgeons. This is the first study assessing its impact in a head and neck surgical oncology clinic, examining the effect on various parameters.

Methods

Retrospective analysis was conducted on a database, analysing and comparing all new patients reviewed 6 months prior to (pre-SUS group) and 6 months following (post-SUS group) the introduction of SUS to the outpatient head and neck surgical oncology clinic. The numbers of radiology imaging investigations (ordered through a medical imaging department), fine-needle aspirations (FNAs) performed, clinical appointments and time to definitive treatment decision were analysed and compared.

Results

A total of 365 patients were included: 169 in the pre-SUS group and 196 in the post-SUS group. There was a statistically significant difference in the number of total radiological imaging investigations performed (1.60 vs. 0.70, p < 0.00001), radiologist-performed FNAs (0.24 vs. 0.10, p = 0.0234), time for definitive treatment decision being made (16.4 days vs. 11.6 days, p = 0.04338), and number of clinical encounters (3.03 vs. 2.29, p < 0.00001). No statistically significant difference was observed in the number of head and neck surgical oncology clinic appointments (1.70 vs. 1.66, p = 0.6672).

Conclusion

Surgeon-performed ultrasound reduces the number of radiological imaging investigations and FNAs performed, reduces time for definitive treatment decision being made, and reduces the number of clinical encounters for patients. This supports its use in head and neck cancer setting and has important implications for both patients and the health-care system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Yes.

References

  1. Patel R, Skandarajah AR, Gorelik A, Shears MJ, Tasevski R, Miller JA (2018) One-stop thyroid nodule clinic with same-day fine-needle aspiration cytology improves efficiency of care. ANZ J Surg 88:354–358

    Article  Google Scholar 

  2. National Institute of Clinical Excellence (NICE) (2004) Guidance on cancer services. Improving outcomes in head and neck cancer. The manual. NICE, London

    Google Scholar 

  3. Linkhorn H, Pandya H, Ramsaroop R, Wade M, Smith K (2019) Neck lump clinic: a new initiative at North Shore Hospital. ANZ J Surg 89:853–857

    Article  Google Scholar 

  4. Carneiro-Pla D, Amin S (2014) Comparison between preconsultation ultrasonography and office surgeon-performed ultrasound in patients with thyroid cancer. World J Surg 38:622–627

    Article  Google Scholar 

  5. Monteiro R, Han A, Etiwy M, Swearingen A, Krishnamurthy V, Jin J et al (2018) Importance of surgeon-performed ultrasound in the preoperative nodal assessment of patients with potential thyroid malignancy. Surgery 163:112–117

    Article  Google Scholar 

  6. Zheng M, Plonowska KA, Strohl MP, Ryan WR (2018) Surgeon-performed ultrasound for the assessment of parotid masses. Am J Otolaryngol 39:467–471

    Article  Google Scholar 

  7. Moshtaghi O, Haidar YM, Mahmoodi A, Tjoa T, Armstrong WB (2017) The role of in-office ultrasound in the diagnosis of neck masses. Otolaryngol Head Neck Surg 157:58–61

    Article  Google Scholar 

  8. Flatman S, Kwok MMK, Magarey MJR (2020) Introduction of surgeon-performed ultrasound to a head and neck clinic: indications, diagnostic adequacy and a new clinic model? ANZ J Surg. 90:861–866

    Article  Google Scholar 

  9. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al (2016) 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133

    Article  Google Scholar 

  10. Colevas AD, Yom SS, Pfister DG, Spencer S, Adelstein D, Adkins D et al (2018) NCCN guidelines insights: head and neck cancers, version 1.2018. J Natl Compr Canc Netw 16:479–490

    Article  Google Scholar 

  11. Ahn D, Kim H, Sohn JH, Choi JH, Na KJ (2015) Surgeon-performed ultrasound-guided fine-needle aspiration cytology of head and neck mass lesions: sampling adequacy and diagnostic accuracy. Ann Surg Oncol 22:1360–1365

    Article  Google Scholar 

  12. Ahn D, Sohn JH, Yeo CK, Jeon JH (2016) Feasibility of surgeon-performed ultrasound-guided core needle biopsy in the thyroid and lymph nodes. Head Neck 38(Suppl 1):E1413–E1418

    Article  Google Scholar 

  13. Maniakas A, Christopoulos A, Bissada E, Guertin L, Olivier MJ, Malaise J et al (2017) Perioperative practices in thyroid surgery: an international survey. Head Neck 39:1296–1305

    Article  Google Scholar 

  14. Fernandes VT, De Santis RJ, Enepekides DJ, Higgins KM (2015) Surgeon-performed ultrasound guided fine-needle aspirate biopsy with report of learning curve; a consecutive case-series study. J Otolaryngol Head Neck Surg 44:42

    Article  Google Scholar 

  15. Gu WX, Tan CS, Ho TW (2014) Surgeon-performed ultrasound-guided fine-needle aspiration cytology (SP-US-FNAC) shortens time for diagnosis of thyroid nodules. Ann Acad Med Singapore 43:320–324

    PubMed  Google Scholar 

  16. Bohacek L, Milas M, Mitchell J, Siperstein A, Berber E (2012) Diagnostic accuracy of surgeon-performed ultrasound-guided fine-needle aspiration of thyroid nodules. Ann Surg Oncol 19:45–51

    Article  Google Scholar 

  17. Dale W, Bilir P, Han M, Meltzer D (2005) The role of anxiety in prostate carcinoma: a structured review of the literature. Cancer 104:467–478

    Article  Google Scholar 

  18. Novy DM, Price M, Huynh PT, Schuetz A (2001) Percutaneous core biopsy of the breast: correlates of anxiety. Acad Radiol 8:467–472

    Article  CAS  Google Scholar 

  19. Lodewijk L, Vriens MR, Vorselaars WM, van der Meij NT, Kist JW, Barentsz MW et al (2016) Same-day fine-needle aspiration cytology diagnosis for thyroid nodules achieves rapid anxiety decrease and high diagnostic accuracy. Endocr Pract 22:561–566

    Article  Google Scholar 

  20. Layeequr Rahman R, Crawford S, Hall T, Bavosi D, Quinlan R (2008) Surgical-office-based versus radiology-referral-based breast ultrasonography: a comparison of efficiency, cost, and patient satisfaction. J Am Coll Surg 207:763–766

    Article  Google Scholar 

  21. Al-azawi D, Mann GB, Judson RT, Miller JA (2012) Endocrine surgeon-performed US guided thyroid FNAC is accurate and efficient. World J Surg 36:1947–1952

    Article  Google Scholar 

  22. Cozens NJ (2009) A systematic review that evaluates one-stop neck lump clinics. Clin Otolaryngol 34:6–11

    Article  CAS  Google Scholar 

  23. Flukes S, Garry S, Hinton-Bayre A, Lindsay A (2019) Pre-treatment wait time for head and neck cancer patients in Western Australia: description of a new metric and examination of predictive factors. ANZ J Surg 89:858–862

    Article  Google Scholar 

Download references

Acknowledgements

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Head and Neck Surgical Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia

    Matthew M. K. Kwok, Keith Wai Keong Choong, Jagdeep Virk, Matthew J. R. Magarey & Samuel Flatman

Authors
  1. Matthew M. K. Kwok
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keith Wai Keong Choong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jagdeep Virk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthew J. R. Magarey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Samuel Flatman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Data collection and statistical analysis: MMKK and KWKC; preparation of the manuscript: all authors.

Corresponding author

Correspondence to Matthew M. K. Kwok.

Ethics declarations

Conflict of interest

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kwok, M.M.K., Choong, K.W.K., Virk, J. et al. Surgeon-performed ultrasound in a head and neck surgical oncology clinic: saving time and improving patient care. Eur Arch Otorhinolaryngol 278, 2455–2460 (2021). https://doi.org/10.1007/s00405-020-06344-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-06344-6

Keywords

Search

Navigation