OBJECTIVE:

Our objective was to analyze the diagnostic measures and management methods for benign and malignant lesions localized in the parotid gland and to assess the role of radiological imaging, fine-needle aspiration biopsy (FNAB), the type and extent of surgery in respect to histopathology of the lesion and subsequent functional results.

METHODS:

The data of 79 parotidectomies performed in our clinic between October 2005 and December 2010 were retrospectively reviewed. Age, gender, clinical findings, FNAB cytology, radiological evaluation, surgical methods, histopathological evaluation, and complications were recorded.

RESULTS:

The distribution of the lesions found on the 79 patients was as follows: 59 benign (75 %), 19 malignant (24 %), and one inflammatory (1 %). The most common benign tumor was pleomorphic adenoma (69 %), the most common malignant tumor was acinic cell carcinoma (15.8 %). The mean age of patients with malignant tumor was significantly higher than the mean age of patients with benign tumors. The accuracy rate of FNAB was 90.63 % for malignant tumors and 76.56 % for benign tumors. The 37 pleomorphic adenomas localized in the superficial lobe and the 13 Warthin’s tumors were managed with superficial parotidectomy, whereas the 12 malignant and 5 benign tumors localized in the deep lobe were removed with total parotidectomy. The most common complication in our series was facial paralysis (5%).

CONCLUSION:

Despite the significant contribution of FNAB cytology particularly in malignant-benign differentiation, the diagnosis of parotid gland lesions should include either clinical and radiological data as complementary to FNAB cytology data. Ultrasonography, owing to the low cost and no risk of radiation exposure characteristics, may be used routinely for locating superficial lobe masses. CT and MRI may be reserved for malignant and selected benign cases. Our surgical preference was superficial parotidectomy in superficial benign parotid masses whereas total parotidectomy in deep-lobe benign tumors and advanced-stage malignant tumors.

Keywords: parotid tumor, fine-needle aspiration biopsy, parotidectomy