Prospective randomized clinical trial of the effect of needle size on pain, sample adequacy and accuracy in head and neck fine-needle aspiration cytology.

Abstract: Background. Fine-needle aspiration cytology(FNAC) is useful in the diagnosis of many conditions of the headand neck. No reported studies have investigated the optimalneedle gauge in the head and neck region.Methods. This was a prospective randomized trial of 100patients who required FNAC performed with either a 21G or 23Gneedle. Discomfort was scored by patients using a visual ana-logue scale. Sample accuracy was assessed in patients whosubsequently had excision biopsy.Results. FNAC performed with a 23G needle was less painful(mean 6 SE, 1.6 6 1.01) than FNAC with a 21G needle (3.3 61.94; p < .001). There was no difference in sample adequacybetween the 2 needle sizes (p ¼ .59). The sensitivities and spe-cificities of both needles were similar.Conclusion. Head and neck FNAC should routinely be per-formed with a 23G needle, resulting in less patient discomfort,and giving sample adequacy comparable to a conventional 21Gneedle. VV C 2007 Wiley Periodicals, Inc. Head Neck 29: 919–922, 2007Keywords: fine-needle aspiration cytology; needle size; neck;lump