[Ultrasound in oromaxillofacial surgery]

Ultrasonography has gained acceptance in maxillofacial surgery as a first-choice diagnostic tool in soft tissue masses of the head and neck. To date, A-mode sonography of the maxillary sinus is only performed in children and pregnant women. However, B-mode sonography is primarily performed in the assessment of all cervical lymph nodes because of its superior sensitivity in comparison to CT and MR, as well as in diseases of the salivary glands, solid tumors, and monitoring of distraction osteogenesis of the mandible. With color-coded ultrasonography as a combination of B-mode and blood flow information, vessels of the head and neck area or of planned flaps can be examined in a noninvasive manner. This is especially important in secondary microsurgical reconstructions. Moreover, the blood flow in any soft tissue masses can be evaluated. In spite of all texture and image analysis techniques, positive and negative lymph nodes cannot be differentiated in a safe manner. Three-dimensional sonography, e.g., panoramic pictures, and contrast enhancement are new technologies that will improve diagnostic accuracy of head and neck ultrasonography.