Kraft M, Lang F, Mihaescu A, Wolfensberger M. Evaluation of clinician-operated sonography and fine-needle aspiration in the assessment of salivary gland tumours.
Clin Otolaryngol 2008;
33:18-24. [PMID:
18302546 DOI:
10.1111/j.1749-4486.2007.01598.x]
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Abstract
OBJECTIVES
To evaluate the combination of ultrasound (US) + fine-needle aspiration (FNA) in the assessment of salivary gland tumours in the hands of the otolaryngologist.
DESIGN
A retrospective review of case notes was performed.
SETTING
Two university teaching hospitals in Switzerland.
PARTICIPANTS
One hundred and three patients with a total of 106 focal masses of the salivary glands were included. Clinician-operated US + FNA were the first line of investigation for these lesions. All patients underwent surgical excision of the lesion, which allowed for confirmation of diagnosis by histopathology in 104 lesions and by laboratory testing in two lesions.
MAIN OUTCOME MEASURES
Primary--diagnostic accuracy in identifying true salivary gland neoplasms and detecting malignancy. Secondary--predicting an approximate and specific diagnosis in these tumours.
RESULTS
The combination of US + FNA achieved a diagnostic accuracy of 99% in identifying and differentiating true salivary gland neoplasms from tumour-like lesions. In detecting malignancy, this combination permitted an accuracy of 98%. An approximate diagnosis was possible in 89%, and a specific diagnosis in 69% of our patients.
CONCLUSIONS
Due to economic factors and a high diagnostic accuracy, the combination of US + FNA represents the investigation method of choice for most salivary gland tumours. We suggest that the otolaryngologist be employed in carrying out these procedures, as is already the rule in other medical specialties, while computed tomography and magnetic resonance imaging should be reserved to those few lesions, which cannot be delineated completely by sonography.
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