Intra-Operative Per-Oral Ultrasonography to guide resection of the Deep surgical tumor- free margins in Carcinoma tongue.

Lurstep Wanshnong; Tirkey A.J; Vasanth M.S.; Pranay G.; Muthusami John C.; John Reetu; Anuradha C.M.; Meera Thomas

Volume : V, Issue : IX, September - 2016

Intra-Operative Per-Oral Ultrasonography to guide resection of the Deep surgical tumor- free margins in Carcinoma tongue.

Lurstep Wanshnong, Tirkey A. J, Vasanth M. S. , Pranay G. , Muthusami John C. , John Reetu, Anuradha C. M. , Meera Thomas

Abstract :

Introduction: Squamous cell carcinoma(SCC) of the oral tongue is the second most common sub site in the oral cavity malignancy in India. Surgery being the first modality of treatment, needs a 1.5 cm three dimensional resection margins in order to achieve proper tumor oncological clearance. The deep margins are the one which is usually compromised. Can per-operative image guided excision be done to aid the surgeon in adequate resection? So as not to compromise on the specialized function of the tongue or the tumor clearance. Methods: A prospective non-randomized pilot study with a sample size of 15 who were newely diagnosed SCC of oral tongue between June, 2013 and March, 2014. A finger probe was use to mark the deep soft tissue margin of 1.5 cm from the deep edge of the tumor. The depth of the tumor and the post operative resection margin was again measured sonographically immediately following the excision of the tumor specimen. This was correlated with the final histopathological depth of the tumor and the margin. The findings were analyzed using descriptive statistics and correlation co-efficient calculated using SPSS17. Results: The mean deep soft tissue pathological margin was 1.2 cm (SD 4.1). Sonographically measured tumor depth had a positive correlation of 0.955while the deep soft tissue margin had a correlation of 0.261with the final histopathology. Conclusion: Intra-operative sonography using the finger-probe is feasible and simple technique to measure the depth of tumor in the carcinoma of the oral tongue and helps achieving the desired resection margin