Clinic and sonography in combination with core needle biopsy for preoperative assessment of parotid tumors – evaluation of the Augsburg Salivary Gland Center.

Introduction Preoperative assessment of parotid tumors is crucial for the therapy and choice of surgery. Clinical symptoms, sonography, and fine or core needle biopsy (FNA or CNB) are important to assess the dignity.

Material and method A retrospective study evaluated 971 patients (572 m, 392 w) who underwent parotid tumor surgery from 2014 to 2021. Preoperative assessment was compared with histologic diagnosis. It was analyzed whether the selected surgical technique was correctly indicated. All tumors were assessed clinically and sonographically (B-scan, color Doppler, from 2019 elastography). In case of suspicion of the presence of a malignancy, a FNA was performed for surgery planning, from 2019 a CNB.

Results A comparison of the preoperative suspected diagnosis with the postoperative histologically confirmed diagnosis showed an incorrect assessment in 37 cases (3.8%). In 34 cases (3.50%) with preoperative suspicion of a benign parotid tumor, the postoperative diagnosis turned out to be a malignancy. In 19 of these cases (56%), no further surgical therapy was required. In 15 patients (44%), a second surgery intervention was performed for oncologic reasons. However, only 5 patients (0.5%) required a repeat dissection of the facial nerve. In 3 patients (0.30%) with preoperative suspicion of malignancy, benign findings were found postoperatively.

Discussion and Conclusion Clinical examination, together with multimodal sonography including elastography and CNB in case of suspected malignancy have high accuracy for the assessment of dignity and surgical procedure in parotid tumors in the clinical setting of a high-volume center.

Publication History

Article published online:
12 May 2023