Tongue cancer. Sonographic assessment of tumor stage.

In an effort to improve preoperative evaluation of tumors of the tongue, a prospective study on the value of ultrasound (US) for the staging of 50 surgically proven cancers of the tongue and floor of mouth was performed. Sonography was correlated with clinical staging and surgical outcome. Real-time high-frequency transducers and an echo-free silicone interface were used. The dorsal and middle thirds of the tongue were scanned from a submental access and the tip of the tongue directly. US accurately defined tumor sizes and locations in all cases. US staged cancers correctly in all cases but one. In contrast, clinical staging was correct in only 66% of cases. Surgically relevant details, such as crossing of the midline of the tongue or infiltration of the lateral pharyngeal wall, were detected with US. The major limitations of US include the nonvisualization of the epiglottis and retropharyngeal space as well as bone infiltration.