[Toluidine blue in monitoring of recurrences and second primary tumors in patients treated for oral cavity and pharynx cancer].

Assesment of recurrences in the oral cavity and pharynx is a serious diagnostic challenge particularly in patient after surgery and irradiation. Observed visible local lesions like oedema, formation of postoperative scars and pain made the diagnostic procedure difficult. Sometimes it's impossible to distinguish recurrences and inflammatory reaction. The aim of this research was to evaluate the usefulness of toluidyne blue in monitoring of recurrences and second primary tumors in the patients with oral and pharyngeal cancer. It was perform by comparison of the three methods: physical examination, endoscopic ultrasound probe and toluidine blue staining in detection of early malignancy. A group of 80 patients with oral and pharyngeal squamous cell cancer was treated in the years between 2000-2003 in the Department of Otolaryngology in Poznań. In 7 positive tested cases toluidine blue staining was confirmed in histological examination. 3 cases were false-positive staining (patients after reconstructive with infrahyoid and pectoral major flap).

CONCLUSIONS

(1) toluidine blue staining is cheap effective diagnostic procedure in monitoring recurrences in patients after surgery and irradiation; (2) procedure is limited in patients after reconstructive flap surgery; (3) ultrasound endoscopy is of value in assesment of advanced tumors of oral cavity and pharynx, but it's limited in flat and superficial mucosal infiltrations.