The Role of Immediate Ultrasound-Guided Fine-Needle Aspiration Cytology by Specialist Head and Neck Surgeons in a One-Stop Clinic: A Single-Centre Retrospective Analysis

Background Ultrasound-guided fine-needle aspiration cytology (US-FNAC) is a minimally invasive diagnostic technique widely used for evaluating head and neck masses. In most centres, these procedures are performed by radiologists; however, increasing service demands have resulted in delays and diagnostic backlogs, with potential for adverse effects on outcomes. A solution to this could be the use of US-FNAC performed by specialist head and neck surgeons in a one-stop neck lump clinic. Limited data exists in the current literature on US-FNAC led by head and neck surgeons. Objective To assess the adequacy and effectiveness of US-FNAC samples collected by head and neck surgeons in a dedicated neck lump clinic. Primary outcomes were diagnostic yield, turnaround time, and the need for subsequent imaging. Methods A retrospective review was conducted over a 38-month period at a single National Health Service (NHS) centre. A total of 129 patients presenting with neck lumps, excluding thyroid cases, were included. Data collected included US-FNAC sample adequacy, cytology result turnaround time, and the rate of subsequent imaging following the procedure. Results Of the 129 patients, 85 (66%) yielded adequate samples for cytological diagnosis. Among these, 58 (68%) were diagnostic, while 27 (32%) were non-diagnostic and required further imaging. The mean turnaround time from US-FNAC to cytology report was five calendar days, equivalent to three working days. Subsequent imaging was performed in 116 cases (89%), primarily for patients with inadequate or non-diagnostic results. Conclusion Immediate US-FNAC performed by specialist head and neck surgeons within a one-stop clinic achieves high diagnostic adequacy with minimal delay. This approach supports timely multidisciplinary decision-making, optimises the diagnostic pathway, and offers a feasible solution to the increasing demand on radiology departments for head and neck cancer diagnostics.