Retrospective analysis of pathological and surgical results of parotidectomy cases in our clinic

Öz

Salivary gland tumors are most commonly located in the parotid gland and and their treatment is parotidectomy. Tumors constitute the majority of parotidectomy indications, with recurrent parotitis and sialadenitis being other indications. The purpose of our study is to investigate the etiology, histopathological and surgical results of parotidectomy and the diagnostic power of magnetic resonance imaging (MRI) and fine-needle aspiration biopsy (FNAB). Patients who underwent parotidectomy at our clinic between August 2020 and December 2024 were included in our study. Patient demographics, reasons for surgery, MRI, FNAB and final pathology results and any complications were recorded retrospectively. Patients under the age of 18 and those with incomplete information were excluded from the study. A total of 42 patients with a mean age of 53 were included in our study. Sixteen of the patients had pleomorphic adenoma, 13 had Warthin’s tumor and 7 had malignant tumor. Complications were observed in 2 patients. The sensitivity of FNAB was calculated as 73.8%, while the sensitivity of MRI was 47.6%, and it was observed that the success of correct diagnosis did not differ according to age, side, and gender. It was observed that the accordance between MRI and FNAB was slight. In conclusion, our study revealed that parotidectomy is most often performed as a superficial parotidectomy for benign masses. The complication rates and sensitivity of FNAB rate in our case series were similar to those in the literature, but the sensitivity of MRI was lower than that of literature.

Anahtar Kelimeler

• Parotid gland
• pathology
• ; parotid neoplasms
• magnetic resonance imaging
• fine-needle aspiration biopsy

Etik Beyan

Our study was conducted with approval from the Konya City Hospital ethics committee (2025/162-08.09.2025) and in accordance with the Declaration of Helsinki.

Kliniğimizdeki parotidektomi vakalarının patolojik ve cerrahi sonuçlarının retrospektif analizi

Öz

Tükürük bezi tümörleri en sık parotis bezinde bulunur ve tedavisi parotidektomidir. Tümörler, parotidektomi endikasyonlarının çoğunluğunu oluştururken, tekrarlayan parotit ve siyaladenit diğer endikasyonlardır. Çalışmamızın amacı, parotidektominin etiyolojisini, histopatolojik ve cerrahi sonuçlarını, manyetik rezonans görüntülemesinin (MRG) ve ince iğne aspirasyon biyopsisinin (İİAB) tanısal gücünü araştırmaktır. Ağustos 2020 ile Aralık 2024 tarihleri arasında kliniğimizde parotidektomi operasyonu yapılan hastalar çalışmamıza dahil edildi. Hastalara ait demografik bilgileri, ameliyat nedenleri, MRG, İİAB ve nihai patoloji sonuçları ve varsa herhangi bir komplikasyon retrospektif olarak kaydedildi. 18 yaşın altındaki hastalar ve eksik bilgiye sahip olan hastalar çalışmadan çıkarıldı. Çalışmamıza ortalama yaşı 53 olan toplam 42 hasta dahil edildi. Hastaların 16'sında pleomorfik adenom, 13'ünde Warthin tümörü ve 7'sinde malign tümör vardı. 2 hastada komplikasyon gözlendi. İİAB duyarlılığı %73,8, MRG duyarlılığı ise %47,6 olarak hesaplandı ve doğru tanı başarısının yaş, taraf ve cinsiyete göre farklılık göstermediği gözlemlendi. MRG ve İİAB arasındaki uyumun düşük olduğu görüldü. Çalışmamız, parotidektominin benign kitleler için en sık yüzeyel parotidektomi olarak yapıldığını ortaya koydu. Vaka serimizdeki komplikasyon oranları ve İİAB duyarlılık oranı literatürdekilerle benzerdi, ancak MRG duyarlılığı literatürdekinden daha düşüktü.

Anahtar Kelimeler

• Parotid bez
• patoloji
• parotis tümörleri
• manyetik rezonans görüntüleme
• ince iğne aspirasyon biyopsisi

Destekleyen Kurum

yok

Etik Beyan

Çalışmamız Konya Şehir Hastanesi etik kurulunun onayı (2025/162-08.09.2025) ile ve Helsinki Bildirgesi'ne uygun olarak yürütülmüştür.

Teşekkür

yok

Kaynakça

1. 1. Britt CJ, Stein AP, Patel PN, Harari PM, Hartig GK. Incidental parotid neoplasms: pathology and prevalence. Otolaryngology--Head and Neck Surgery. 2015;153(4):566-8.
2. 2. Rzepakowska A, Osuch-Wójcikiewicz E, Sobol M, Cruz R, Sielska-Badurek E, Niemczyk K. The differential diagnosis of parotid gland tumors with high-resolution ultrasound in otolaryngological practice. European Archives of Oto-Rhino-Laryngology. 2017;274(8):3231-40.
3. 3. Zoccali F, Cialente F, Colizza A, Ralli M, Greco A, de Vincentiis M. Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma. European Archives of Oto-Rhino-Laryngology. 2023;280(7):3329-35.
4. 4. Yıldız E, Kuzu S, Günebakan Ç, Özdemir M, Bucak A, Kahveci OK. Is the combined use of ultrasonography (USG) and fine needle aspiration biopsy (FNAB) safe in parotis masses? Retrospective comprehensive comparison of 123 cases. Irish Journal of Medical Science (1971-). 2023;192(4):1861-5.
5. 5. Erdim İ, Sapmaz E, Somuk BT, Turan A. Baş-boyun cilt kanserlerinde parotidektomi: Klinik deneyimimiz. Praxis of Otorhinolaryngology/Kulak Burun Boğaz Uygulamaları. 2022;10(3).
6. 6. Zheng M, Plonowska KA, Strohl MP, Ryan WR. Surgeon-performed ultrasound for the assessment of parotid masses. American Journal of Otolaryngology. 2018;39(5):467-71.
7. 7. Hamour AF, O’Connell D, Biron VL, Allegretto M, Seemann R, Harris JR, et al. Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses. Ear, Nose & Throat Journal. 2024;103(6):NP340-NP4.
8. 8. Yaslikaya S, Altuntas A. Parotid masses: The effectiveness of preoperative diagnostic methods on definitive diagnosis. Ann Med Res 2022;29(9):1054–8.

9. 9. Şahin MM, Çayönü M, Cılız DS, Tuna EEÜ, Dinç ASK, Boynueğri S, et al. Magnetic Resonance Imaging versus Fine Needle Aspiration Biopsy in the Differential Diagnosis of Neoplastic Parotid Gland Lesions. ENT Updates. 2019;9(1):38-43.
10. 10. Özdamar K, Aydın S, Altaş B, Yücebaş K, Altınay S, Öğreden Ş, et al. Parotis bezi kitlelerinde ince iğne aspirasyon biyopsisinin önemi. KBB Uygulamaları. 2015;3:20-4.
11. 11. Eravcı FC, Cılız DS, Özcan KM, Çolak M, Çavuşoğlu M, Karakurt SE, et al. Conventional and diffusion-weighted MR imaging findings of parotid gland tumors. Turkish archives of otorhinolaryngology. 2020;58(3):174.
12. 12. Cho HW, Kim J, Choi J, Choi HS, Kim ES, Kim S-H, et al. Sonographically guided fine-needle aspiration biopsy of major salivary gland masses: a review of 245 cases. American Journal of Roentgenology. 2011;196(5):1160-3.
13. 13. Pusztaszeri M, Rossi ED, Faquin WC. Update on salivary gland fine-needle aspiration and the Milan System for Reporting Salivary Gland Cytopathology. Archives of Pathology & Laboratory Medicine. 2024;148(10):1092-104.
14. 14. Colella G, Cannavale R, Flamminio F, Foschini MP. Fine-needle aspiration cytology of salivary gland lesions: a systematic review. J Oral Maxillofac Surg. 2010;68(9):2146-53.
15. 15. Hughes JH, Volk EE, Wilbur DC. Pitfalls in salivary gland fine-needle aspiration cytology: lessons from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology. Archives of pathology & laboratory medicine. 2005;129(1):26-31.
16. 16. Chowdhury Z, Majumdar P, Narain S, Lamba K. The Myriad Spectrum of Salivary Gland Lesions: Cytohistological Correlation on Fine Needle Aspiration Cytology, Core Needle Biopsy, and Resections in a 5-Year Single Institutional Experience of North India. Diagn Cytopathol. 2025;53(8):391-401.
17. 17. Romano EB, Wagner JM, Alleman AM, Zhao L, Conrad RD, Krempl GA. Fine-needle aspiration with selective use of core needle biopsy of major salivary gland tumors. Laryngoscope. 2017;127(11):2522-7.
18. 18. Tretiakow D, Mikaszewski B, Skorek A. The role of fine‑needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. Eur Arch Otorhinolaryngol. 2020;277(10):2939-40.
19. 19. Shetty A, Geethamani V. Role of fine-needle aspiration cytology in the diagnosis of major salivary gland tumors: A study with histological and clinical correlation. Journal of Oral and Maxillofacial Pathology. 2016;20(2):224-9.
20. 20. Dostalova L, Kalfert D, Jechova A, Koucky V, Novak S, Kuchar M, et al. The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. European Archives of Oto-Rhino-Laryngology. 2020;277(6):1763-9.
21. 21. Eissa L, Abou Seif S, El Desooky S, Eid M, Koraitim T. Accuracy assessment of combined diffusion weighed and dynamic gadolinium MR sequences in characterization of salivary gland tumors. The Egyptian Journal of Radiology and Nuclear Medicine. 2016;47(1):127-39.
22. 22. Li Z-Q, Gao J-N, Xu S, Shi Y, Liu X, Li X, et al. Multimodal magnetic resonance imaging for the diagnosis of parotid gland malignancies: systematic review and meta-analysis. Translational cancer research. 2022;11(7):2275.
23. 23. Pâris P, Fath L, Schultz P, Veillon F, Riehm S, Severac F, et al. Diffusion-weighted and gadolinium-enhanced dynamic MRI in parotid gland tumors. European Archives of Oto-Rhino-Laryngology. 2023;280(1):391-8.