Intraoperative B-mode endosonography of tongue carcinoma

BACKGROUND: Exact estimation of a tumor's size and definition of adequate resection margins in carcinomas of the tongue are often difficult because of the tumor's extension and deep infiltration. METHODS: We developed a method that allows intraoperative visualization and marking of tumor margins: intraoperative endosonography was performed in five patients with carcinomas of the tongue with an 8- to 12-MHz linear array transducer. The oral cavity was flooded with normal saline solution, and the transducer was immersed therein. This allowed scanning in a noncontact mode. The tumor margins were marked with a surgical suture under endosonographic monitoring. RESULTS: In the five patients studied, histologic margins corresponded to sonographic margins. The sonographic marking proved to be useful during the resection of the tumor, and histologic safety margins were respected in each case. CONCLUSIONS: This noninvasive procedure provides a quick and reliable orientation during resection of tongue carcinoma, and a more precise and individual definition of resection margins is possible. Intraoperative noncontact use of endosonography is a promising method, and further studies may confirm this.