This is an old revision of the document!
Vetting Guidance
All guidance contained within represents suggested local practice from Derriford consultants, but is only general guidance - do not apply blindly and where uncertainty persists ask someone.
By pathology (malignancies):
Suspected ENT Cancer
This covers suspected upper aerodigestive tract, major salivary gland tumours, and neck lymphadenopathy with unknown primary.
If low risk:
- Non-contrast MRI neck
If high risk:
- MRI neck with contrast
- CT thorax with contrast
Risk Stratification:
LOW RISK Patients - MNECK - no contrast: - Have 2WW symptoms - e.g. referred otalgia, chronic lateralising throat pain, FOSIT - Have NORMAL examination including fibre-optic nasendoscopy. - No palpable suspicious neck lumps (by ENT/MaxFacs) or normal neck US. - No previous H&N malignancy/treatment. - Following multiple normal surveillance studies, can change to non-contrast surveillance.
HIGH RISK Patients - MNECKC - contrast: - Have abnormal examination on FNE - suspicious nasal, pharyngeal or laryngeal mass. - Oral cavity lesion on MaxFacs examination. - Abnormal neck lump (ideally confirmed as pathological on US). - Post-treatment patients / suspected recurrence.