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Otolaryngologist-performed head and neck ultrasound: outcomes and challenges in learning the technique

Published online by Cambridge University Press:  05 June 2014

K Badran ,
P Jani  and
L Berman
K Badran*
Affiliation:
Department of ENT, Addenbrooke's Hospital, Cambridge, UK
P Jani
Affiliation:
Department of ENT, Addenbrooke's Hospital, Cambridge, UK
L Berman
Affiliation:
Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
*
Address for correspondence: Mr K Badran, 66 Balforn Drive, Coatbridge ML5 4FF, UK E-mail: Badran99@hotmail.com
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Abstract

Objective:

To assess the feasibility and accuracy of otolaryngologist-performed ultrasound in evaluating head and neck pathology.

Method:

An ENT trainee, who had undergone basic training in neck ultrasonography, performed this on patients referred with suspected neck pathology. The trainee recorded the presence and nature of any abnormality. Findings were compared with those from a repeated scan performed by an experienced head and neck radiologist.

Results:

The study included 250 patients. The absence or presence of lesion as reported by the trainee correlated with the radiologist's findings in 207 cases (83 per cent). There were 144 true positives, 63 true negatives, 32 false negatives and 11 false positives, yielding a sensitivity of 82 per cent, specificity of 85 per cent and accuracy of 83 per cent. Of the 144 true positive lesions, 81 per cent were interpreted concordantly with the radiologist.

Conclusion:

Neck ultrasonography performed by an otolaryngologist is less accurate than that performed by an experienced radiologist, but is still a useful adjunct to clinical assessment, facilitating assessment in a ‘one-stop’ clinical setting.

Keywords

UltrasonographyNeckAbnormalitiesOtolaryngology

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 5 , May 2014 , pp. 447 - 453
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Rozycki, GS, Ochsner, MG, Jaffin, JH, Champion, HR. Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients. J Trauma 1993;34:516–26Google Scholar
2Rozycki, GS, Feliciano, DV, Schmidt, JA, Cushman, JG, Sisley, AC, Ingram, W et al. The role of surgeon-performed ultrasound in patients with possible cardiac wounds. Ann Surg 1996;223:737–46Google Scholar
3Ultrasound clinical governance (National Ultrasound Steering Group, 2008). In: http://www.bmus.org/policies-guides/ClinicalGovernanceInUltrasound-061108.pdf [22 March 2014]Google Scholar
4Developing and Growing the Sonographer Workforce: Education and Training Needs (The Society and College of Radiographers, 2009). In: http://www.sor.org/learning/document-library/developing-and-growing-sonographer-workforce-education-and-training-needs [22 March 2014]Google Scholar
5Ultrasound Training Recommendations for Medical and Surgical Specialties, 2nd edn (The Royal College of Radiologists, 2005). In: http://www.rcr.ac.uk/docs/radiology/pdf/BFCR(12)17_ultrasound_training.pdf [22 March 2014]Google Scholar
6Jabiev, AA, Lew, JI, Solorzano, CC. Surgeon-performed ultrasound: a single institution experience in parathyroid localization. Surgery 2009;146:569–75Google Scholar
7Van Ginhoven, TM, Morks, AN, Schepers, T, de Graaf, PW, Smit, PC. Surgeon-performed ultrasound as preoperative localization study in patients with primary hyperparathyroidism. Eur Surg Res 2011;47:70–4CrossRefGoogle ScholarPubMed
8Solorzano, CC, Carneiro-Pla, DM, Irvin, GL. Surgeon-performed ultrasonography as the initial and only localizing study in sporadic primary hyperparathyroidism. J Am Coll Surg 2006;202:18–24CrossRefGoogle ScholarPubMed
9Mazzaglia, PJ. Surgeon-performed ultrasound in patients referred for thyroid disease improves patient care by minimizing performance of unnecessary procedures and optimizing surgical treatment. World J Surg 2010;34:1164–70CrossRefGoogle ScholarPubMed
10Iannotti, JP, Ciccone, J, Buss, DD, Visotsky, JL, Mascha, E, Cotman, K et al. Accuracy of office-based ultrasonography of the shoulder for the diagnosis of rotator cuff tears. J Bone Joint Surg Am 2005;87:1305–11Google ScholarPubMed
11Yiengpruksawan, A, Ganepola, GP, Freeman, HP. Extended applications of ultrasonography by the surgeon. A preliminary report. Am J Surg 1987;153:221–5CrossRefGoogle ScholarPubMed
12Rozycki, GS, Pennington, SD, Feliciano, DV. Surgeon-performed ultrasound in the critical care setting: its use as an extension of the physical examination to detect pleural effusion. J Trauma 2001;50:636–42Google Scholar
13Whitehouse, PA, Baber, Y, Brown, G, Moskovic, E, King, DM, Gui, GP. The use of ultrasound by breast surgeons in outpatients: an accurate extension of clinical diagnosis. Eur J Surg Oncol 2001;27:611–16Google Scholar
14Kell, MR, Aherne, NJ, Coffey, C, Power, CP, Kirwan, WO, Redmond, HP. Emergency surgeon-performed hepatobiliary ultrasonography. Br J Surg 2002;89:1402–4Google Scholar
15Buzzas, GR, Kern, SJ, Smith, RS, Harrison, PB, Helmer, SD, Reed, JA. A comparison of sonographic examinations for trauma performed by surgeons and radiologists. J Trauma 1998;44:604–8CrossRefGoogle ScholarPubMed
16Filly, RA. Ultrasound: the stethoscope of the future, alas. Radiology 1998;167:400Google Scholar
17Staren, ED, Knudson, MM, Rozycki, GS, Harness, JK, Wherry, DC, Shackford, SR. An evaluation of the American College of Surgeons' ultrasound education program. Am J Surg 2006;191:489–96Google Scholar
18Ultrasound training by radiology departments for other medical specialties: resource implications and requirements (The Royal College of Radiologists, 2007). In: http://www.rcr.ac.uk/docs/radiology/pdf/ultrasoundtraining.pdf [22 March 2014]Google Scholar
19Fang, R, Pilcher, JA, Putnam, AT, Smith, T, Smith, DL. Accuracy of surgeon-performed gallbladder ultrasound. Am J Surg 1999;178:475–9Google Scholar
20Knudtson, JL, Dort, JM, Helmer, SD, Smith, RS. Surgeon-performed ultrasound for pneumothorax in the trauma suite. J Trauma 2004;56:527–30CrossRefGoogle ScholarPubMed
21Leslie, A, Lockyer, H, Virjee, JP. Who should be performing routine abdominal ultrasound? A prospective double-blind study comparing the accuracy of radiologist and radiographer. Clin Radiol 2000;55:606–9CrossRefGoogle ScholarPubMed
22Chen, SC, Lin, FY, Hsieh, YS, Chen, WJ. Accuracy of ultrasonography in the diagnosis of peritonitis compared with the clinical impression of the surgeon. Arch Surg 2000;135:170–4Google Scholar
23Rahman, RL, Crawford, S, Hall, T, Bavosiet, D, Quinlan, R. Surgical-office-based versus radiology-referral-based breast ultrasonography: a comparison of efficiency, cost, and patient satisfaction. J Am Coll Surg 2008;207:763–6Google Scholar
24American Society of Breast Surgeons. Breast Ultrasound Certification. In: https://www.breastsurgeons.org/new_layout/programs/certification/breast_ultrasound_certification.php [22 March 2014]Google Scholar
25Rozychi, GS, Strauch, GO. Ultrasound for the general surgeon: an ACS initiative. Bull Am Coll Surg 1998;83:37–9Google Scholar
26Society of American Gastrointestinal and Endoscopic Surgeons. Guidelines for granting of ultrasonography privileges for surgeons. In: http://www.sages.org/publications/guidelines/guidelines-for-granting-of-ultrasonography-privileges-for-surgeons/ [22 March 2014]Google Scholar
27Grosfield, JL. American Board of Surgery. Bull Am Coll Surg 1996;81:57–60Google Scholar
28Rozychi, GS. Surgeon-performed ultrasound: its use in clinical practice. Ann Surg 1998;228:16–28Google Scholar
29Mateer, J, Plummer, D, Heller, M. Model curriculum for physician training in emergency ultrasound. Ann Emerg Med 1994;23:95–102CrossRefGoogle Scholar
30Shackford, SR, Rogers, FB, Osler, TM, Trabulsy, ME, Clauss, DW, Vane, DW. Focused abdominal sonogram for trauma: the learning curve of nonradiologist clinicians in detecting hemoperitoneum. J Trauma 1999;46:553–64CrossRefGoogle ScholarPubMed
31American Institute of Ultrasound in Medicine. Ultrasound practice accreditation. In: http://www.aium.org/accreditation/accreditation.aspx [22 March 2014]Google Scholar