Ultrasonography for evaluation of the carotid artery in head and neck cancer.

The dynamic relationship of lymph node metastases to surrounding vascular structures in the neck is important for preoperative patient assessment. When carotid artery involvement is suspected, this relationship often determines whether or not to operate. In the case of adhesive neck metastases along the internal jugular vein, it becomes possible to predict preoperatively if the integrity of this vein may be preserved. Ultrasonography has the ability to differentiate subtle from gross adherence, or simple compression from vascular invasion. This is done by manually palpating the tumor mass and asking the patient to perform various maneuvers while observing on a monitor the relationship of th…