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Position Statement: Surgeon Performed Neck Ultrasound

Position Statement: Surgeon Performed Neck Ultrasound
Position Statement: Surgeon Performed Neck Ultrasound

April 21, 2021

The American Academy of Otolaryngology-Head and Neck Surgery strongly endorses the practice of providing patients with timely, effective, efficient, and patient-centered diagnostic imaging studies and interpretation by appropriate qualified specialists. All otolaryngologists receive training in head and neck imaging studies as part of their medical specialty training, and it is a component of the Scope of Knowledge for Board Certification.

Otolaryngologists have been utilizing and interpreting point-of-care ultrasound use since 1993. Ultrasound is widely used to evaluate the neck, oral cavity, salivary glands, vocal folds, airway, and vasculature in adults and children.

The AAO-HNS supports surgeons performing ultrasound of the head and neck, including ultrasound-guided fine needle aspiration for diagnostic purposes. Neck ultrasound is not an extension of the physical exam, but rather a discrete diagnostic procedure.

Adopted 3/20/2016
Reaffirmed 6/9/2021
Revised April 2025

References:

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  2. American Medical Association. H-230.960 Privileging for Ultrasound Imaging. https://www.ama-assn.org/ssl3/ecomm/PolicyFinderForm.pl?site=www.ama-assn.org&uri=/resources/html/PolicyFinder/policyfiles/HnE/H-230.960.HTM
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  11. Dehqanzada ZA, Meisinger Q, Doucet J, et al. Complete ultrasonography of trauma in screening blunt abdominal trauma patients is equivalent to computed tomographic scanning while reducing radiation exposure and cost. J Trauma Acute Care Surg. 2015;79(2):199-205.
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  13. Gallagher PV, Elliott ST, Charnley R. Appraising surgeons learning sonography: measuring measurement variability. J Clin Ultrasound. 2003 Sep;31(7):364-368.
  14. Gu WX, Tan CS, Ho TW. Surgeon-performed ultrasound-guided fine-needle aspiration cytology (SP-US-FNAC) shortens time for diagnosis of thyroid nodules. Ann Acad Med Singapore. 2014;43(6):320-324.
  15. Gurney TA, Orloff LA. Otolaryngologist-head and neck surgeon-performed ultrasonography for parathyroid adenoma localization. Laryngoscope. 2008;118(2):243-246.
  16. Henry-Tillman R, Glover-Collins K, Preston M, et al. The SAVE review: sonographic analysis versus excision for axillary staging in breast cancer. J Am Coll Surg. 2015;220(4):560-567.
  17. Hwang HS, Orloff LA. Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer. Laryngoscope. 2011;121(3):487-491.
  18. Hwang HS, Perez DA, Orloff LA. http://www.ncbi.nlm.nih.gov/pubmed/19688854 Laryngoscope. 2009;119(10):1958-1965.
  19. Layeequr Rahman R, Crawford S, Hall T, Bavosi D, Quinlan R. Surgical-office-based versus radiology-referral-based breast ultrasonography: a comparison of efficiency, cost, and patient satisfaction. J Am Coll Surg. 2008;207(5):763-766.
  20. Lee CY, Snyder SK, Lairmore TC, Dupont SC, Jupiter DC. Utility of surgeon-performed ultrasound assessment of the lateral neck for metastatic papillary thyroid cancer. J Oncol. 2012;2012:973124. Epub 2012/02/01. doi: 10.1155/2012/973124.
  21. Lee L, Steward DL. Sonographically-directed neck dissection for recurrent thyroid carcinoma. Laryngoscope. 2008;118(6):991-994.
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  23. Oltmann SC, Schneider DF, Chen H, Sippel RS. All thyroid ultrasound evaluations are not equal: sonographers specialized in thyroid cancer correctly label clinical N0 disease in well differentiated thyroid cancer. Ann Surg Oncol. 2015;22(2):422-8.
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  25. Roe SM, Mathews JA, Burns RP, et al. Stereotactic and ultrasound core needle breast biopsy performed by surgeons. Am J Surg. 1997;174(6):699-703.
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  27. Ryan WR, Orloff LA. Intraoperative tumor localization with surgeon-performed ultrasound-guided needle dye injection. Laryngoscope. 2011;121(8):1651-1655.
  28. Soon PS, Delbridge LW, Sywak MS, et al. Surgeon performed ultrasound facilitates minimally invasive parathyroidectomy by the focused lateral mini-incision approach. World J Surg. 2008;32(5):766-771.
  29. Steward DL, Danielson GP, Afman CE, Welge JA. Parathyroid adenoma localization: surgeon-performed ultrasound versus sestamibi. Laryngoscope. 2006;116(8):1380-1384.
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  32. Ultrasound Examinations by Surgeons. American College of Surgeons Committee on Emerging Surgical Technology and Education. https://www.facs.org/about-acs/statements/31-ultrasound-exam. June 1, 1998.
  33. Whitehouse PA, Baber Y, Brown G, et al. The use of ultrasound by breast surgeons in outpatients: an accurate extension of clinical diagnosis. Eur J Surg Oncol. 2001;27(7):611-616.
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  36. Liao LJ, Wen MH, Yang TL. Point-of-care ultrasound in otolaryngology and head and neck surgery: a prospective survey study. J Formos Med Assoc. 2021;120:1547–53. https:// doi. org/ 10. 1016/j. jfma. 2021. 02. 021.
  37. Harb JL, Zaro C, Nassif SJ, Dhingra JK. Point-of-care ultrasound scan as the primary modality for evaluating parotid tumors. Laryngoscope Investigative Otolaryngology. 2022;7(5):1402‐1406. doi:10. 1002/lio2.887
  38. Zhang WQ, Lambert EM, Ongkasuwan J. Point of care, clinician-performed laryngeal ultrasound and pediatric vocal fold movement impairment. Int J Pediatr Otorhinolaryngol. 2020;129:109773. doi:10.1016/j.ijporl.2019.109773
  39. Chen C.N., Lin C.Y., Ko J.Y., Lou P.J., Wang C.P., Chen T.C., et. al.: Application of ultrasound-guided core biopsy as a novel diagnostic tool for base of tongue cancer: our experiences with ten patients. Clin Otolaryngol 2015; 41: pp. 86-90.
  40. Ho U.C., Chen C.N., Lin C.Y., Hsu Y.C., Chi F.H., Chou C.H., et. al.: Application of ultrasound-guided core biopsy to minimize the non-diagnostic results and the requirement of diagnostic surgery in extrapulmonary tuberculosis of the head and neck. Eur Radiol 2016; 26: pp. 2999-3005.
  41. Park AC, Hutchison DM, Prasad KR, et al. Costal Cartilage Considerations: Novel Use of Handheld Ultrasound Device in Rhinoplasty. Laryngoscope. 2024;134(2):651-653. doi:10.1002/lary.30760
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  43. Gibbons RC, Costantino TG. Evidence-Based Medicine Improves the Emergent Management of Peritonsillar Abscesses Using Point-of-Care Ultrasound. J Emerg Med. 2020;59(5):693-698. doi:10.1016/j.jemermed.2020.06.030
  44. Dhingra JK. Ultrasound-Guided Fine-Needle Biopsy of First 1000 Consecutive Thyroid Nodules: Single-Surgeon Experience. OTO Open. 2020;4(2):2473974X20929008. Published 2020 Jun 2. doi:10.1177/2473974X20929008

Important Disclaimer Notice (updated 7/31/14)

Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.

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