Ultrasound‐guided versus free‐hand fine‐needle aspiration cytology of the parotid gland: A single‐centre, retrospective review

• Published in: Surgical practice 2018-08, Vol.22 (3), p.111-115
• Main Authors: Hung, Dorothy Sze‐Wing, Lai, Emily Yat‐Ling
• Format: Article
• Language: English
• Subjects: Cellular biology; Exocrine glands; fine‐needle aspiration cytology; lesion; parotid gland; Ultrasonic imaging; ultrasound
• ISSN: 1744-1625; 1744-1633
• DOI: 10.1111/1744-1633.12315

Aim Fine‐needle aspiration cytology (FNAC) is a commonly‐used diagnostic tool to evaluate lesions of the parotid gland. However, ultrasound‐guided FNAC requires expertise, which might not always be immediately available. Free‐hand FNAC can be readily arranged at an outpatient clinic setting, and could shorten waiting time and allow rapid diagnosis of parotid lesions. The aim of our study was to evaluate the accuracy and yield of free‐hand FNAC versus ultrasound‐guided FNAC and its subsequent correlation to the final pathology in order to evaluate its use as a preoperative investigational tool. Patients and Methods A retrospective review was carried out for patients who underwent superficial, partial or total parotidectomy at the Queen Elizabeth Hospital by the general surgical team between 1 January 2008 and 31 March 2016. Results for 176 surgeries performed were analysed. In total, 155 cases with preoperative FNAC of the parotid were included in the study. Results Ultrasound‐guided FNAC had 100 per cent specificity, whereas free‐hand FNAC had 98.3 per cent specificity for detecting malignancy. Sensitivity was 92.9 per cent in the ultrasound‐guided FNAC group versus 90 per cent in the free‐hand FNAC group. Ultrasound‐guided FNAC offered a preoperative diagnosis as to whether a mass was benign or malignant in 21 out of 75 patients (28 per cent), while free‐hand FNAC was able to do so in 15 out of 80 patients (18.8 per cent). However, this was not statistically significant (P = 0.188). Conclusion Overall, both ultrasound‐guided and free‐hand FNAC have high sensitivity and specificity for diagnosing malignancy preoperatively. Free‐hand FNAC does not have a lower yield and was not shown to be statistically inferior to ultrasound‐guided FNAC. Free‐hand FNAC is a good alternative in certain cases where the parotid lesion can be easily accessible.