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6.9.10: 10. Imaging

  • Page ID
    53887
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    Imaging for Oropharyngeal Cancer

    Imaging only required if it may change management

    Distant pulmonary metastases / synchronous primary: CXR / CT chest

    If radiation planned

    • Panorex to exclude dental disease or bone destruction
    • Imaging (CT/ MRI) to plan radiation

    Imaging of Primary

    • T1: Rarely require imaging
    • T2: Consider CT scan prior to transoral resection to determine position of carotid artery
    • T3
      • Trismus: Rule out involvement of masticator space, PPS and ITF (CT scan)
      • If abuts mandible to decide about marginal / segmental / hemimandibulectomy (CT / Panorex)
    • Choice of imaging
      • Soft tissue: CT / MRI
      • Bone: Panorex / CT scan / MRI
      • Perineural spread: MRI

    Cervical metastases

    • N0 neck: No need to image if elective neck dissection planned, unless concern about occult contralateral (base of tongue, soft palate) or retropharyngeal nodes
    • N+ neck: Image (U/S or CT) if concern about resectability

    6.9.10: 10. Imaging is shared under a CC BY-NC 3.0 license and was authored, remixed, and/or curated by Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery.