Intraoral ultrasonography with wrapped acoustic coupling medium.

C n patients with cancer of the tongue, the thickness and depth f the tumour are important independent prognostic facors for local recurrence, subclinical nodal metastasis, and urvival.1–3 Intraoral ultrasonography is useful for assessng both factors,1–3 and intraoral colour Doppler sonography elps to predict delayed cervical lymph node metastases in arly-stage cancer of the tongue.2 Without the use of echo elly, direct contact of the probe with an oral lesion can lead o poor quality images, (and can also cause discomfort), and epeated use of the probe may transmit pathogens if it is ot cleaned properly. To address these issues we wrapped n acoustic coupling medium in fresh cling film for each xamination. In 2014, we used a mobile ultrasound system (Fujifilm oldings Corporation, Tokyo, Japan) fitted with a 10.2 MHZ -shaped “hockey stick” probe for intraoral assessment of ore than 30 people with cancer of the tongue. We cut an coustic coupling medium 3 mm thick (Sonagel®, Takiron o Ltd, Tokyo, Japan) to fit the probe, (Fig. 1) and attached t using cling film (Fig. 2). We used it to measure the thickess of lesions and the depth of invasion in B-mode, (Fig. 3) here it reliably and repeatedly provided good quality images Fig. 4). After each examination the film was replaced, which nabled the apparatus to be reused safely and easily. To overcome the poor-quality images, transmission of nfection, and discomfort to the patient, Shinozaki et al3 preiously reported using an ultrasound probe with echo jelly as