Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T07:02:57.529Z Has data issue: false hasContentIssue false
  • English
  • Français

Selective fine needle aspiration of parotid masses. FNA should be performed in all patients older than 60 years

Published online by Cambridge University Press:  25 May 2010

S M Kieran ,
M McKusker ,
I Keogh  and
C Timon
S M Kieran*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
M McKusker
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
I Keogh
Affiliation:
Academic Department of Otolaryngology, National University of Ireland, Galway, Ireland
C Timon
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
*
Address for correspondence: Mr Stephen Kieran, Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Adelaide Rd, Dublin 2, Ireland. E-mail: skieran@rcsi.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The exact role of fine needle aspiration in the pre-operative assessment of patients presenting with parotid masses is controversial. Some surgeons propose that fine needle aspiration be performed only selectively in those patients with likely malignant disease, whilst others recommend it for all patients presenting with such a mass. Intuitively, one would expect older patients to be more likely to suffer from primary malignant parotid tumours and secondary deposits of malignant skin tumours. Therefore, we hypothesised that older patients with a parotid mass should undergo fine needle aspiration regardless of their medical history.

Design:

We retrospectively reviewed 197 consecutive parotidectomies to test this hypothesis.

Results:

One hundred and twenty-one patients (61.4 per cent) were diagnosed with benign disease, whilst 76 (38.6 per cent) were diagnosed with malignant disease. Eighty-three per cent of patients aged 60 years or younger had benign disease, as opposed to 35.6 per cent of patients aged more than 60 years. Malignant disease occurred more commonly in patients older than 60 years (odds ratio 8.962, 95 per cent confidence interval 4.607–17.434).

Conclusion:

In patients with a parotid mass, fine needle aspiration should be performed on all those aged 60 years or older.

Keywords

Parotid NeoplasmsNeedle BiopsyCytologyAge
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 975 - 979
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Scottish Intercollegiate Guidelines Network. Diagnosis and Management of Head and Neck Cancer. Scottish Intercollegiate Guidelines Network: Edinburgh, 2006;8Google Scholar
2 American Head and Neck society. Practice Guidelines: Parotid. In: http://www.headandneckcancer.org/clinicalresources/docs/parotid.php [23 April 2010]Google Scholar
3Cohen, EG, Patel, SG, Lin, O, Boyle, JO, Kraus, DH, Singh, B et al. Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg 2004;130:773–8Google Scholar
4Pinkston, JA, Cole, P. Incidence rates of salivary gland tumours: results from a population-based study. Otolaryngol Head Neck Surg 1999;120:834–40CrossRefGoogle ScholarPubMed
5Eveson, JW, Cawson, RA. Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age and sex distribution. J Pathol 1985;14:51–8CrossRefGoogle Scholar
6Alphs, HH, Eisele, DW, Westra, WH. The role of fine needle aspiration in the evaluation of parotid masses. Curr Opin Otolaryngol Head Neck Surg 2006;14:62–6CrossRefGoogle ScholarPubMed
7Lin, AC, Bhattacharyya, N. The utility of fine needle aspiration in parotid malignancy. Otolaryngol Head Neck Surg 2007;136:793–8CrossRefGoogle ScholarPubMed
8Batsakis, JG, Sueige, N, el-Nagger, AK. Fine needle aspiration of salivary glands: its utility and tissue effects. Ann Otol Rhinol Laryngol 1992;101:185–8CrossRefGoogle ScholarPubMed
9Al-Khafaji, BM, Nestok, BR, Katz, RL. Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center. Cancer 1998;84:153–93.0.CO;2-P>CrossRefGoogle ScholarPubMed
10Postema, RJ, van Velthuysen, ML, van den Brekel, MW, Balm, AJ, Peterse, JL. Accuracy of fine-needle aspiration cytology of salivary gland lesions in the Netherlands Cancer Institute. Head Neck 2004;26:418–24CrossRefGoogle ScholarPubMed
11Zbaren, P, Schar, C, Hotz, MA, Loosli, H. Value of fine-needle aspiration cytology of parotid gland masses. Laryngoscope 2001;111:1989–92CrossRefGoogle ScholarPubMed
12Lurie, M, Misselevitch, I, Fradis, M. Diagnostic value of fine-needle aspiration from parotid gland lesions. Isr Med Assoc J 2002;4:681–3Google ScholarPubMed
13Cajulis, RS, Gokaslan, ST, Yu, GH, Frias-Hidvegi, D. Fine needle aspiration biopsy of the salivary glands: a five-year experience with emphasis on diagnostic pitfalls. Acta Cytol 1997;41:1412–20CrossRefGoogle ScholarPubMed
14Zbaren, P, Nuyens, M, Loosli, H, Stauffer, E. Diagnostic accuracy of fine-needle aspiration cytology and frozen section in primary parotid carcinoma. Cancer 2004;100:1876–83CrossRefGoogle ScholarPubMed
15Seethala, RR, LiVolsi, VA, Baloch, ZW. Relative accuracy of fineneedle aspiration and frozen section in the diagnosis of lesions of the parotid gland. Head Neck 2005;27:217–23CrossRefGoogle ScholarPubMed
16Contucci, AM, Corina, L, Sergi, B, Fadda, G, Paludetti, G. Correlation between fine-needle aspiration biopsy and histologic findings in parotid masses: personal experience. Acta Otorhinolaryngol Ital 2003;23:314–18Google ScholarPubMed
17Balakrishnan, K, Castling, B, McMahon, J, Imrie, J, Feeley, KM, Parker, A et al. Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study. Surgeon 2005;3:67–72CrossRefGoogle Scholar
18Stow, N, Veivers, D, Poole, A. Fine-needle aspiration cytology in the management of salivary gland tumors: an Australian experience. Ear Nose Throat J 2004;83:128–31CrossRefGoogle ScholarPubMed
19Bahar, G, Dudkiewicz, M, Feinmesser, R, Joshua, BZ, Braslavsky, D, Popovtzer, A et al. Acute parotitis as a complication of fine-needle aspiration in Warthin's tumor. A unique finding of a 3-year experience with parotid tumor aspiration. Otolaryngol Head Neck Surg 2006;134:646–9CrossRefGoogle ScholarPubMed
20Van Lierop, AC, Fagan, JJ. Parotidectomy in Cape Town – a review of pathology and management. S Afr J Surg 2007;45:9/6–8Google Scholar