Computed tomography-guided wire localization - An intraoperative tool for head and neck resections

With the increasing sophistication of computed tomography and magnetic resonance imaging of the head and neck, it is not uncommon to locate a lesion radiographically that cannot be detected clinically. The complex anatomy and abundance of vital structures in the head and neck can make surgical localization of these targets difficult. Although computed tomography (CT)-guided fine-needle aspiration (FNA) is now routinely used(1.2) to diagnose suspicious lesions in the head and neck, we report 2 cases in which CT-guided localized wire was used as an intraoperative tool. Specifically, we describe 2 cases in which a localization wire was placed under CT guidance before surgery and used to guide the dissection for lesions in particularly tenuous locations. One of our cases involved a malignant recurrence in the setting of previous surgical resections, and the other involved a foreign body lodged within the neck and spinal canal.