A lean neck mass clinic model: Adding value to care. (8th August 2015)

• Record Type: Journal Article
• Authors: Tillman, Brittny N.; Glazer, Tiffany A.; Ray, Amrita; Brenner, J. Chad; Spector, Matthew E.
• Is Part Of: Laryngoscope. Volume 125:Number 11(2015:Nov.)
• Page Start: 2509
• Page End: 2513
• Publication Date: 2015-08-08
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25535
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25535-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To demonstrate that ultrasound‐guided fine needle aspiration (USFNA) with on‐site cytopathologic analysis eliminates unnecessary diagnostic testing, return visits, and repeat procedures and optimizes quality of care.</p> </sec> <sec id="lary25535-sec-0002" sec-type="section"> <title>Study Design</title> <p>Retrospective cohort.</p> </sec> <sec id="lary25535-sec-0003" sec-type="section"> <title>Methods</title> <p>Sixty‐one new patients (28 female; 33 male; age range = 19–85 years) were seen in our dedicated neck mass clinic over a 1‐year period. All patients underwent USFNA of masses located in neck levels I–VI (n = 40), parotid gland (n = 20), or parapharyngeal space (n = 1). Each patient underwent two USFNA passes followed by on‐site cytopathologic analysis with additional passes if required for diagnosis.</p> </sec> <sec id="lary25535-sec-0004" sec-type="section"> <title>Results</title> <p>Diagnosis was made in 93.4% (n = 57) of patients, allowing for counseling and treatment planning at the first visit. To obtain a diagnosis, more than half (57.4%, n = 35) of our patients required additional passes, which implies that they would have required an additional visit without on‐site cytopathologic analysis. Treatment included observation in 42.6% (n = 26) of patients, surgery in 32.8 % (n = 20) of patients, and nonsurgical treatment (chemotherapy, radiation, other) in 24.6% (n = 15) of patients. The average time from check‐in to checkout including the clinic visit, biopsy, and treatment counseling was 103 minutes, and the average round trip mileage traveled per patient was 127.6 miles.</p> </sec> <sec id="lary25535-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The adult neck mass is a commonly encountered scenario in otolaryngology. For the patient, this can be a stressful situation in which timely and accurate diagnosis is critical. A dedicated lean neck mass clinic model with USFNA and on‐site cytopathologic analysis can be both an efficient part of one's practice and a valuable addition to patient care.</p> </sec> <sec id="lary25535-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4 <italic>Laryngoscope</italic>, 125:2509–2513, 2015</p> </sec> </abstract>