| Cancers of larynx and hypopharynx are malignant tumors in head and neck . Although clinical examination , laryngoscope and biopsy provide important information in tumor diagnosis ,as to its deep infiltration and lymph metastasis, evaluation cant be given accurately before operation . Lymph metastases not only affect tumor grade, stage and handling principle , but also influence patient's prognosis. The false positive rate and false negative rate of palpation to lymphoid metastasis is 4 ~ 42% , 0 ~ 77% , respectively. High resolution ultrasound is a promising technicpie in assessment of laryngeal carcinoma, yet few published studies have appeared concerning its use. We set out to assess if ultrasound could correctly identify lesions, if extrala-ryngeal spread or nodal involvement could be shown by ultrasound. The neck of 37 patients with laryngeal and hypopharyngeal cancer were observed, the results were correlated with surgery and with histo - pathological findings, aims at evaluating US in diagnosis of larynx and hypopharynx cancer, also at finding the US characteristics relating to the histology of metastatic carcinoma in lymph nodes.Materials and methods1 ObjectivesThirty seven patients with squamous cell carcinoma of larynx and hypopharyx who underwent operation at the ear - nose - larynx department , First affliated hospital, China Medical University , served as subjects during a pierod of 17 months, from July ,2001 to December , 2002. The patients consisted of 29 men and 8 women ranging in age from 34 to 79 years with a mean age of 53y. Primary tumor sites, in decreasing order of frequency, were 25 of laryngeal carcinoma, (17 of epiglottic ,4 of glottic, 2 of infra - glottic ,2 of trans - glottic) ,5 of hypo - pharygeal carcinoma ( piriform fossa type ) . 7 patients underwent first surgery of primary tumor with 6 of larynx and 1 of hypopharyx.2. MethodsUltrasonogrphyAll the ultrasound investigations were performed using a linear array transducer with frequency 5-12 MHz, ( ATL - HDI 5000 US system , Washington, USA).The technique of laryngeai US involves systematic identification of specific structures in the following order; transverse slice was scanned at levels of hyoid bone, thyroid cartilage, vocal folds, ventricle cords and cricoid cartilage , Longitudinal slice was scanned along with para - larynx . Particular attention was paid to the demonstration of vocal cord mobility and the relation of the tumor (if visible) to surrounding structures.The patient's neck was scanned at different levels(6 - level). When lymph node was detected, distribution was first recorded basedon 6 levels ,then size( the maximal longitudinal diameter, maximal axis diameter, shape index) , shape , intensity of internal echoes, hilus (existence of echogenic hilus or not) ,necrosis , edge definition characteristic and pattern of margin for individual detected lymph nodes were evaluated as diagnostic parameters, CDE of lymph node was observed as parameter ,too.The relations of enlarged nodes and great cervical vessels was determined on the movement between vessels and nodes by pressure or touching the nodes , if no movement was detected , adhered cervical node was identified.To guarantee the lymph node's consistency, surgeon recorded the dissected lymph nodes, such as location, size, shape, architecture and surrounding structure during operation with UICC neck division method, similar to ultrasonography and pathology. The lymph nodes consistent to the US findings were histologic examinations. The specimens were fixed and embedded in paraffin, then continuous sections were obtained at 6 jx m intervals, slices were stained by HE, observed by an experienced pathologist with optical microscope .3. Statistical analysisThe maximal longitude diameter , maximal axis diameter and shape index of lymph nodes were compared by un - paired t - test; the internal echo, hilar echo, capsule, necrosis and CDE vascular type of lymph nodes were compared by chi - square test in two groups. The correlatio...
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