TITLE:
Evaluation of Preoperative Fine Needle Aspiration Accuracy in Diagnosis of Malignant Parotid Tumors
AUTHORS:
Alaa Q. Mandeel, Esra M. Qadami, Zahra A. Abdeen, Sayed Ali I. Al Mahari, Sayed Husain A. Alawi
KEYWORDS:
Fine Needle Aspiration, Histopathology, Malignant, Parotid, Salmaniya Medical Complex, Tumors
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.9 No.3,
May
22,
2020
ABSTRACT: Objective: To evaluate the diagnostic accuracy of fine needle aspiration (FNA) in detecting malignant parotid tumors. Design: A retrospective study of cases series. Setting: Salmaniya Medical Complex, Otorhinolaryngology Department, Kingdom of Bahrain. Methods: A retrospective study was carried out, between January 2009 and December 2018, for all patients diagnosed with parotid tumors at the Department of Otorhinolaryngology, Head and Neck Surgery at Salmaniya Medical Complex, Manama, Kingdom of Bahrain. Data collection was made from medical records, I-seha and laboratory information system (LIS). 87 patients underwent parotidectomy, of which 30 were excluded due to unsatisfactory diagnoses or missing data. The results of fine needle aspirations were analyzed and compared with the corresponding histopathologic diagnosis. Estimation of sensitivity, specificity, negative predictive value, positive predictive value and accuracy of FNA were calculated. Results: Among the 57 evaluated cases, four cases were further excluded from the final analysis due to unsatisfactory FNA results, therefore only 53 cases remained. The mean age of patients was 48.6 ± 17.2 years. A concordance with histopathology results was observed. 47 cases were diagnosed as benign and five cases were malignant, however, 1 case was diagnosed as malignant by FNA, but not in histopathology. The overall diagnostic accuracy was 98.1% and the prevalence of parotid malignancy was 9.4%. Sensitivity and specificity were 100% and 97.9%, respectively. Positive predictive value was 83.3% while negative predictive value was 100%. Conclusion: Fine needle aspiration is a highly sensitive and specific test in evaluating malignant parotid gland tumors. It is useful and accurate, especially when used hand by hand with the clinical assessment and radiological findings.