Abstract Introduction Squamous cell Carcinoma of the Head and Neck (HNSCC) is the most common tumor entity of malignant processes in the head and neck area. Due to the metastasizing behavior of these tumors, the staging is indispensable for the treatment planning and requires imaging techniques, which are sensitive, specific, and as far as possible cost-effective, to benefit ultimately the patient and to ensure optimal care. Objectives The aim of the present study is to compare the clinical examination including palpation, ultrasound and computed tomography (CT)/magnetic resonance imaging (MRI) for the diagnosis of neck metastases to make the correct indication for a neck dissection. Methods Data from 286 patients with HNSCC were analyzed for neck metastases to determine which diagnostic tool is the best to answer the question if a neck dissection is necessary or not. Each study method was examined retrospectively by comparing sensitivity, specificity, the positive/negative predictive value, the positive likelihood ratio and the diagnostic accuracy. Results The ultrasound showed a sensitivity of 91.52%, a specificity of 61.67%, a positive/negative predictive value of 76.65%/84.09%, a positive likelihood ratio of 2.39 and a diagnostic accuracy of 78.95%. The clinical examination showed a sensitivity of 75.76%, a specificity of 66.12%, a positive/negative predictive value of 75.30%/66.67%, a positive likelihood ratio of 2.24 and a diagnostic accuracy of 71.68%. The CT/MRI showed a sensitivity of 78.66%, a specificity of 62.50%, a positive/negative predictive value of 74.14%/68.18%, a positive likelihood ratio of 2.10 and a diagnostic accuracy of 71.83%. Radiographically, ultrasound, as well as the clinical examination, could be judged to be free from radiation load and side effects from the contrast medium. The high dependence on the investigator when using ultrasound made reproducibility of the results difficult. Conclusions It could be shown that ultrasound was the diagnostic tool with the highest sensitivity, positive/negative predictive value, positive likelihood ratio and diagnostic accuracy by detecting and interpreting metastases in the head and neck region correctly. Whether a neck dissection should be performed depends to a large extent on the ultrasound findings.

Partindo da ênfase recente que a teoria das nações vem dando ao caráter imaginado ou "construído" da comunidade nacional, este artigo procura estabelecer pontes com a teoria antropológica e analisar as implicações desse movimento para uma antropologia das identidades étnicas e nacionais. Em particular, seguindo a boa tradição empírica da disciplina, procura-se avaliar essas considerações teóricas tendo em vista possíveis desenvolvimentos da etnografia da formação e das políticas de identidade em contextos nacionais. Nesse sentido, é aqui esboçado o projeto de uma "antropologia do discurso", exemplificada com materiais oriundos de pesquisas sobre identidade nacional na Alemanha e no Brasil. A análise desses dois casos conduz à proposição de uma distinção teórica entre construção da identidade nacional centrada no discurso (Alemanha) e centrada nos símbolos (Brasil).

Starting from the recent emphasis that nation theory has been giving to the "imagined" and/or "constructed" character of the national community, the paper looks for connections with anthropological theory and analyses the implications for anthropologys perspective on national and ethnic identities. In particular, following the traditionally strong empirical orientation of the discipline, it also interprets these theoretical assumptions bearing in mind possible developments in ethnographic research regarding the formation and politics of identity in national settings. In this context, the paper sketches the concept of a "discourse anthropology" with examples from research on national identity in Germany and Brazil. The analysis of these two cases leads to a theoretical distinction between discourse-centred (Germany) and symbol-centred (Brazil) constructions of national identity.