Disease Of Parotid Gland Research Articles

Applying deep learning-based ensemble model to [18F]-FDG-PET-radiomic features for differentiating benign from malignant parotid gland diseases.

To develop and identify machine learning (ML) models using pretreatment 2-deoxy-2-[18F]fluoro-D-glucose ([18F]-FDG)-positron emission tomography (PET)-based radiomic features to differentiate benign from malignant parotid gland diseases (PGDs). This retrospective study included 62 patients with 63 PGDs who underwent pretreatment [18F]-FDG-PET/computed tomography (CT). The lesions were assigned to the training (n = 44) and testing (n = 19) cohorts. In total, 49 [18F]-FDG-PET-based radiomic features were utilized to differentiate benign from malignant PGDs using five different conventional ML algorithmic models (random forest, neural network, k-nearest neighbors, logistic regression, and support vector machine) and the deep learning (DL)-based ensemble ML model. In the training cohort, each conventional ML model was constructed using the five most important features selected by the recursive feature elimination method with the tenfold cross-validation and synthetic minority oversampling technique. The DL-based ensemble ML model was constructed using the five most important features of the bagging and multilayer stacking methods. The area under the receiver operating characteristic curves (AUCs) and accuracies were used to compare predictive performances. In total, 24 benign and 39 malignant PGDs were identified. Metabolic tumor volume and four GLSZM features (GLSZM_ZSE, GLSZM_SZE, GLSZM_GLNU, and GLSZM_ZSNU) were the five most important radiomic features. All five features except GLSZM_SZE were significantly higher in malignant PGDs than in benign ones (each p < 0.05). The DL-based ensemble ML model had the best performing classifier in the training and testing cohorts (AUC = 1.000, accuracy = 1.000 vs AUC = 0.976, accuracy = 0.947). The DL-based ensemble ML model using [18F]-FDG-PET-based radiomic features can be useful for differentiating benign from malignant PGDs. The DL-based ensemble ML model using [18F]-FDG-PET-based radiomic features can overcome the previously reported limitation of [18F]-FDG-PET/CT scan for differentiating benign from malignant PGDs. The DL-based ensemble ML approach using [18F]-FDG-PET-based radiomic features can provide useful information for managing PGD.

Radiologically-guided balloon sialoplasty for benign salivary duct obstruction: a 7-year UK service evaluation

Obstructive sialadenitis is the most common cause of non-malignant salivary gland disorders, with salivary gland strictures being responsible for approximately 23% of all benign obstructive disease. Significant advances in minimally invasive techniques, including radiologically-guided balloon sialoplasty, offer the potential for successful treatment with reduced complications. At present there is a paucity of follow-up data regarding patient outcomes and repeat interventions in those undergoing the procedure. Patients with parotid or submandibular gland sialadenitis secondary to gland stricture were identified and underwent radiologically-guided balloon sialoplasty at Queen Alexandra Hospital, Portsmouth, UK between 2015 and 2022. Patient outcomes, complications and reintervention rates were recorded prospectively over the seven-year period and analysed retrospectively. A total of 44 patients underwent radiologically-guided balloon sialoplasty. Forty (89%) underwent sialoplasty for parotid gland disease, with a minority (n = 5) receiving an intervention for submandibular gland strictures. A total of 37 (84%) had their obstruction successfully treated (82% of parotid gland obstructions and 100% of submandibular gland obstructions). Five patients (11%) required a repeat intervention. Seventeen successfully treated patients (85%) who attended follow-up clinic appointments described complete resolution of their symptoms, with the remaining three (15%) describing a partial response. Radiologically-guided balloon sialoplasty for the treatment of benign obstructive sialadenitis secondary to a gland stricture is a safe and effective method of eliminating the obstruction and relieving patients’ symptoms. Most patients were symptom free at short-term follow up, with a minority requiring a second sialoplastic intervention.

Milan system for reporting salivary gland cytology in diagnosis and surgery of parotid gland lesions

IntroductionA cytology report is always a challenge for both head and neck surgeons and cytopathologists to diagnose and manage parotid gland (PG) diseases, because of the various similar features between the lesions. ObjectivesThe present study was conducted to assess our practice using the Milan System for Reporting Salivary Cytopathology (MSRSGC) and to evaluate the risk of malignancy (ROM) in different categories. Patients and methodsThe patients with parotid gland lesions were diagnosed by clinical examination, ultrasound, and FNAC under ultrasound guidance at our hospital from 1 May 2019 to 30 April 2021. The FNAC results were divided into six categories according to the Milan system. We calculated the ROM for each category of the Milan system based on histopathological follow-up. ResultsThis study included 204 patients. There were 115 men (56 %) aged 46–60 years. Pathology results were 33 cases for malignant and 182 cases for benign. The rate of malignancy for each category according to the MSRSGC were 23.1 % (non-neoplastic), 20 % (atypical), 50 % (neoplastic), 1 % (benign), 10.3 % (salivary neoplasm of uncertain neoplastic potential), 84.6 % (suspicious for malignancy), and 100 % (malignant) categories. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC with application of Milan system were respectively 90.9 %, 98.2 %, 90.9 %, 98.9 % and 97 %. ConclusionWhen the Milan system was applied, FNAC had a high efficacy, suggesting that MSRSGC can improve the communication between the cytopathologist and the surgeon. This system can allow the surgeon to decide the extent of the surgery.

Sialendoscopy as a Useful Diagnostic and Interventional Tool for the Various Salivary Gland Disease: Our Experiences

Background and Objectives Sialendoscopy is useful for the diagnosis and treatment of obstructive salivary gland diseases, but not yet universally employed because it requires dedicate, expensive, and fragile endoscopic equipment; moreover, the surgical technique is also delicate. Here, we describe our initial experience of sialendoscopy, as well as the learning curve, precautions, and drawbacks that beginners must overcome in employing sialendoscopy.Subjects and Method The medical records of 98 patients who underwent sialendoscopic procedures at Eunpyeong St. Mary’s Hospital from May 2019 to March 2022 were retrospectively reviewed. The type of procedure, success rate, operation time, and complications were analyzed.Results We have performed a total of 85 sialendoscopic procedures, including 79 to treat submandibular sialolithiasis, two to treat submandibular ductal stenosis, two to treat parotid sialolithiasis, and two to treat parotid ductal stenosis. Of the total of 81 patients with sialolithiasis, 82.4% were treated by sialendoscopy only, 15.3% by hybrid procedure, and 2.3% opted to preserve the salivary gland and convert to external submandibular gland excision. Four patients with ductal stenosis were treated via endoscopic bougination; stents were placed for 4 weeks without any restenosis. The operation time was significantly shorter for the second half than for the first half of the patients (58.6 min vs. 39.8 min). Longer operation time was associated with the parotid gland diseases, larger stones (&gt;5 mm in diameter), more proximal stones (from the salivary gland), and multiple stones. We encountered no major surgical complications.Conclusion Sialendoscopy is useful and safe; even beginners can evaluate and manage obstructive salivary gland diseases.

Role of Gray Scale and Color Doppler Ultrasound in Diagnosis of Parotid and Submandibular Gland Diseases

Role of Gray Scale and Color Doppler Ultrasound in Diagnosis of Parotid and Submandibular Gland Diseases

PULMONARY INVOLVEMENT WITH PLEOMORPHIC ADENOMA: 30-YEAR EXPERIENCE WITH THIS RARE ENTITY AT A TERTIARY REFERRAL CENTER

PULMONARY INVOLVEMENT WITH PLEOMORPHIC ADENOMA: 30-YEAR EXPERIENCE WITH THIS RARE ENTITY AT A TERTIARY REFERRAL CENTER

Kimura Disease of the Parotid Gland: Management Approach

Here we present a 43-years old Malay man with Kimura’s disease of the right parotid gland. Asian men have a predisposition for this chronic inflammatory disorder of unknown etiology mostly presenting at the head and neck region. The management in dealing with this patient is not straight forward as the presentation mimics a subcutaneous tumor-like mass in which main differential diagnosis includes lymphoproliferative disorders and parotid neoplasm. Moreover, cytological investigation is inadequate, and this necessitates the use intra-operative frozen section prior to tumor debulking. Without proper investigation, misdiagnosis can occur and potentially expose the patient to unnecessary extensive surgical procedures. Here we discuss step by step approach in managing this patient.

Cytomorphology of Castleman’s Disease of Parotid Gland: Pitfalls and Diagnostic Dilemma in a Young Adult

Fine needle aspiration cytology (FNAC) is an easy, effective diagnostic tool that makes it the procedure of choice for all accessible swellings in the body. Castleman’s disease (CD) may present as unicentric or multicentric swelling hence is subjected to FNAC very frequently. CD mainly presents mediastinal nodes, nonetheless when present in salivary glands such as parotid, it is often diagnosed clinically as a salivary gland tumor. However, due to lack of adequate literature on its cytological features and non- specific radiological findings, the condition is often misdiagnosed. There are few case series on cytological features of CD and even fewer cases of CD in the parotid gland. Histopathology serves as the gold standard of diagnosis for CD. In superficial locations, these swellings are easily subjected to direct fine needle aspiration cytology (FNAC). Radiologically guided FNA can be performed for deeper locations. Hence, the authors present a case of 19 year old male patient, who presented with a small superficial, preauricular swelling for FNAC. The initial FNAC yielded no conclusive opinion. however a repeat FNAC and histopathological examination led to the final diagnosis. This case report aims to highlight the cytomorphological and histopathological features of CD in the Parotid gland and various difficulties encountered in making the final diagnosis.

A Contemporary View on the Anatomy of Parotid Gland

One of the up-to-date issues of contemporary medicine is the study of the features of individual anatomical structure variability of various organs. In recent years, the incidence of parotid gland diseases has been rising. This phenomenon can be associated with an absolute increase in this organ pathologies incidence as well as with the development of additional methods of examination and visualization of the gland. Most pathologies of major salivary glands, in particular the parotid gland, require surgical treatment. Knowledge of topographical relationship of the parotid gland with the adjacent vessels and nerve trunks is utterly necessary for planning and performing surgical interventions and reconstructive operations in the parotid region. According to the statistics, surgical interventions on the parotid gland take the leading place among the causes of damage to the facial nerve branches. This fact may also prove a large variation in the syntopy of the facial nerve and the parotid gland. The paper reviews the data of native and foreign literature on the anatomy of parotid gland and the place of radiation research methods in the study of its topographical and anatomical features. The analysis revealed a wide range of anatomical norm of parotid gland in many parameters, including shape, linear size, blood supply, and topographical features. The practice of using anthropometric studies aimed at structuring the existing knowledge and narrowing the borders of anatomical norm for various organs proved to be successful. However, in the pool of scientific papers, we have not found similar studies concerning parotid gland. The facts mentioned above make the background and justify further studies of parotid gland in the context of normal individual variability.

Peroxisomes in the mouse parotid glands: An in-depth morphological and molecular analysis

BackgroundThe parotid gland is a major salivary gland that has important roles in the digestive and immune system. Peroxisomes are ubiquitous, single-membrane-bound organelles that are present in all eukaryotic cells. Peroxisomes help mediate lipid and reactive oxygen species metabolism, as well as polyunsaturated fatty acid, cholesterol and plasmalogen synthesis. Much of the knowledge on peroxisomes has derived from metabolic organs, however no detailed knowledge is available on peroxisomes in the parotid glands. We thus aimed to comprehensively delineate the localization and characterization of peroxisomal proteins in the murine parotid gland. MethodsWe characterized peroxisomes in the acinar and striated duct cells of the murine parotid gland by fluorescence and electron microscopy, as well as protein and mRNA expression analyses for important peroxisomal genes and proteins. ResultsWe found that peroxisomes are present in all cell types of the mouse parotid gland, however, exhibit notable cell-specific differences in their abundance and enzyme content. We also observed that mouse parotid glands contain high levels of peroxisomal β-oxidation enzymes (including Acox1, Mfp2 and Acaa1), catalase and other peroxisomal anti-oxidative enzymes. ConclusionsThis data suggests that peroxisomes are highly abundant in the murine parotid gland and might help to protect against oxidative stress. This comprehensive description of peroxisomes in the parotid gland lays the groundwork for further research concerning their role in the pathogenesis of parotid gland diseases and tumors.

The usefulness of fine needle aspiration cytology in the diagnosis of parotid gland tumors

Background: Various parotid gland diseases are seen clinically including inflammation, sialolithiasis, benign and malignant tumors. It is important to differentiate between these to make a correct diagnosis, the aim of this study is to assess the usefulness of fine needle aspiration cytology as a preoperative diagnostic tool in the diagnosis of parotid gland tumors. Method: A retrospective study was done on 110 Iraqi patients with apparent parotid gland swelling, all patients were subjected to FNAC by using 22-gauge needle attached to a 10ml syringe with at least two needle passes were made for each patient. Results: The number of cases in each category were: nondiagnostic 5.5% and in 94.5% were diagnostic. Neoplastic lesions were observed in 71.20% of patients, non-neoplastic lesions in 28.80% of patient. Conclusion: Fine needle aspiration cytology is a reliable examination providing important information to the surgeon in the preoperative diagnostic assessment when Milan system was applied.

Role of Sialendoscopy in Non-neoplastic Parotid Diseases: A Prospective Study of 241 Patients in Indian Population.

To assess the role of sialendoscopy as a diagnostic modality and in managing cases of non-neoplastic parotid gland diseases. Secondly, to provide descriptive analysis of intraoperative findings. The patients of chronic parotid sialadenitis who presented with complaints of recurrent unilateral or bilateral parotid swelling and pain were included in the study. All patients underwent sialendoscopy, and the findings were noted. Intervention was carried out in the same sitting like dilatation of stenosis, stone removal by basket, combined approach, flushing of mucoid flakes, etc. Failed cases were worked up with radiological investigation and managed accordingly. Two hundred and forty-one cases of parotid sialadenitis who underwent sialendoscopy between 2012 and 2018 were included. Diagnostic sialendoscopy was achieved in 100% cases, while intervention was successful in 96.7% (233/241) cases after the first procedure. On diagnostic sialendoscopy, ductal stenosis was the most common pathology present in 177 (73.4%) patients followed by stones (12%) and debris (11.6%). All cases of stenosis were serially dilated with increasing sizes of sialendoscopes followed by stenting in 75% of the cases. The diagnosis of juvenile recurrent parotitis was confirmed in 17 children (mean age 5.6years) with consistent clinical history and sialendoscopic findings of stenosis along with pale ductal mucosa. There were 18 cases where ductal perforation was seen. One case showed multiple hyperdense foci in bilateral parotid gland along with multiple strictures that underwent repeat sialendoscopy, but the symptoms did not resolve, and finally the patient underwent bilateral superficial parotidectomy. Sialendoscopy is a safe and highly effective modality in managing non-neoplastic parotid gland disorders with low complication rates and resulted in gland preservation in the vast majority of patients. Therefore, it can be concluded that sialendoscopy is the diagnostic and therapeutic modality of choice for parotid obstructive sialadenitis.

Research on the Practical Classification and Privacy Protection of CT Images of Parotid Tumors based on ResNet50 Model

Parotid gland disease is one of the main causes of facial paralysis, and parotid gland tumor is a great threat to the life of patients. The main diagnostic way of parotid diseases is imaging examination, so it is of great significance for the rapid classification of parotid image. In conclusion, 51 CT images of parotid malignant tumors and 101 CT images of parotid pleomorphic adenomas are selected as the research data set, and an intelligent and efficient machine learning algorithm is proposed for the practical classification of parotid images. At the same time, this paper also explores the privacy protection of medical images. Based on the advantages of deep learning, such as no feature engineering, strong adaptability and easy conversion, ResNet50 model in deep learning is selected as the basic network framework to achieve the purpose of rapid classification of parotid CT images. This is the first time that ResNet50 classification algorithm is applied to the practical classification of parotid tumor CT images. The results show that the accuracy of the test set converges to 90% when the model is iterated 1000 times, which also proves that this study has certain practical significance and application value for the auxiliary diagnosis of parotid gland tumor and other head and neck tumors. Simultaneously, this paper also explores the application of desensitization strategy in CT images of parotid tumors, which improves the performance of the model and also greatly protects the privacy of patients, and has a good application prospect in medical big data.

Clinical Presentation and Surgical Outcome of Parotid Gland Tumors- Experience in ENT Department of Rajshahi Medical College Hospital

Objective: To assess the clinical presentation and outcome of surgical treatment of various parotid gland diseases requiring parotidectomy. Setting &amp; design: this was a retrospective study conducted of all patients who underwent different types of parotidectomy in the Department of ENT of Rajshahi Medical College Hospital between January, 2014 to December, 2017.&#x0D; Materials &amp; Methods: Patients presenting with parotid gland disorders requiring various range of parotidectomy admitted in ENT dept. RMCH were included in this study. The location of the tumor and diagnosis was confirmed in every case by advising ultrasound of the parotid region and/or computed tomography scan/MRI along with fine needle aspiration cytology of the swelling. Data regarding age, gender &amp; histology, operative procedure and post-operative complications were meticulously entered in a previously prepared questionnaire for this purpose. Patients were followed up for about two years.&#x0D; Results: Out of 68 patients, 37 (54.4 %) were male and 31 (45.6 %) were female with age ranging from 26 to 63 yrs. with a mean age of 39.5 years. All of them presented with painless parotid lump. 55 Fifty Five Patients (80.9%) had benign pathology while 13 patients (19.1%) had malignancy. Superficial parotidectomy was alone in 48 patients (70.6%), total parotidectomy in 18 (26.5%) patients and extended parotidectomy was performed in 2 cases (2.9%). The most common post-operative complication was numbness of ear lobule (gradually improving with time) in 8 patients (11.8 %), followed by transient facial nerve paresis in 7 patients (10.3%). There was no hospital mortality.&#x0D; Conclusion: Parotid gland disorders affect each gender almost equally. Most of the patients present with benign pathology, superficial parotidectomy is the commonly offered surgical management. All parotid surgeries are safely performed in Department of ENT with minimum morbidity.&#x0D; TAJ 2018; 31(2): 21-26

The Stensen's duct line: A landmark in parotid duct and gland injury and surgery. A prospective anatomical, clinical and radiological study

IntroductionThe parotid duct (PD) is often involved in parotid gland diseases. A skin landmark could help the surgeon to locate its position. The parotid duct line (PDL) joins the tragus-antitragus point to the middle of the half upper lip. The aim of this study was to assess and scientifically validate this landmark. MethodsA monocentric prospective anatomical, clinical and radiological study was conducted. Six fresh cadavers’ PD were dissected. A subcutaneous flap was performed and the PD's position spotted by needle checking through the skin. 10 subjects with parotid obstructive symptoms were included for sialendoscopy, which light through the skin revealed the PDL's position. MRI was conducted on 20 PDs. The radiologist virtually drew the PDL and did a 3D reconstruction of the PD. The distance from the PDL to the PD was measured. ResultsAnatomical study: 2 PDs were on the PDL, 2 under and 2 over.Sialendoscopic study: 6 PDs were on the PDL (60%), 3 under and 1 over. MRI study: 13 over 20 PDs crossed the PDL (65%). Maximum mean distance from the PD was 10.44 mm [5.01–15.87] and minimum mean distance from the PD was 2.42 mm [0–5.75]. DiscussionThis study sought to assess the relevance of the PDL, which is not parallel to the PD that runs a «S-Shape» curve when crossing the PDL. It could be used when evaluating a potential ductal injury in trauma management and when locating proximal parotid lithiasis during sialendoscopy.

The rare entity of cystadenocarcinoma (CAC) in parotid gland: A single-center experience

PurposeCystadenocarcinoma (CAC) is an extremely rare disease in parotid gland. This study aimed to identify the clinical characteristics of CAC, and the therapeutic options for its treatment. An attempt was also made to identify postoperative recurrence-related risk factors. Material and methodsA retrospective study was conducted of CAC patients treated between 2008 and 2018. Predictive factors for postoperative recurrence (5-year RFS rate) were preliminarily filtered by Kaplan–Meier analysis and then further confirmed by a Cox regression model. Postoperative recurrence was defined as the primary outcome variable and was measured using both univariate and multivariate analysis. ResultsA total of 27 patients were analyzed, and the total incidence of postoperative recurrence was 33.3% (9/27). In the Cox regression analysis, patients who received a superficial parotidectomy were 0.046 times more likely to develop tumor relapse than those who only underwent enucleation (p = 0.032; 95% CI: 0.003–0.070). The chances of tumor recurrence in patients with the cribriform subtype were 9.701 times that for cases with a papillary pattern (p = 0.016; 95% CI: 1.517–62.030). The risk of postoperative recurrence increased abruptly, with an OR of 6.373 (p = 0.042; 95% CI: 1.070–37.965), when LN metastasis was found in patients. ConclusionPreoperative diagnosis of CAC in parotid gland is extremely important for allowing surgeons to apply appropriate therapeutic strategies (enucleation or superficial parotidectomy). Patients with LN metastasis, cribriform pattern, and Ki-67 positivity should be treated further to avoid tumor relapse.

Diffusion kurtosis imaging in the differential diagnosis of parotid gland disease and parotid adenolymphoma: preliminary results.

To study the value of diffusion kurtosis imaging (DKI) in diagnosis of parotid gland disease (PGD) with different pathological patterns and parotid adenolymphoma (PAL). 57 patients with different kinds of PGD were enrolled and underwent DKI and conventional diffusion-weighted imaging (DWI). All patients were categorized into different groups according to their pathological patterns. The result of calculating the value of DKI-derived parameters (Kmean, Krad, Kax, Dmean, Drad, Dax, and FA) and apparent diffusion coefficient (ADC) of DWI were used to study their diagnostic accuracy in PGD with different pathological patterns. The binary logistic regression method was used to confirm clinical valuable diffusion parameters (obtained with DKI and DWI models) for diagnosing PAL. Using MedCalc 13.0, receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic value of confirmed parameters based on the logistic regression equation. Both DKI parameters and conventional ADC showed statistical significance in diagnosing PGD with different pathological patterns (p < .01). By using the DKI model, kurtosis coefficients showed higher diagnostic capability than diffusion coefficients ([Kmean+Krad + Kax] vs [Dmean+Drad + Dax]: 22vs15, p < .01) did in the differential diagnosis among different PGD groups. In the diagnosis of PAL among all PGD patterns, the ROC analysis demonstrated that the area under curve (AUC) FA+Kax [0.881 ± 0.057 (0.824 to 0.938)] is higher than that when using FA [0.629 ± 0.095 (0.534 to 0.724)] and Kax [0.800 ± 0.070 (0.730 to 0.870)] alone (p < .05), with sensitivity, specificity, accuracy, and both positive and negative predictive values of 71.43, 95.78, 91.77, 76.92, and 94.44%, respectively. DKI showed higher diagnostic capacity in the differential diagnosis of PGD with different pathological patterns. Combined parameters of DKI can differentiate PAL from other PGD pathological patterns with a high degree of accuracy. This technique shows great potential for DKI in the differential diagnosis of PGD within a certain pathological category.

Diagnostic accuracy of sonoelastography in different diseases.

The objective of this study was to evaluate the diagnostic accuracy of sonoelastography in patients of primary and secondary health care settings. Google scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in October 2017 for all original studies and review articles to identify the relevant material. Two reviewers independently selected articles for evaluation of the diagnostic accuracy of sonoelastography in different diseases based on titles and abstracts retrieved by the literature search. The accuracy of sonoelastography in different diseases was used as the index text, while B-mode sonography, micro pure imaging, surgery and histological findings were used as reference texts. Superficial lymph nodes, neck nodules, malignancy in thyroid nodules, benign and malignant cervical lymph nodes, thyroid nodules, prostate carcinoma, benign and malignant breast abnormalities, liver diseases, parotid and salivary gland masses, pancreatic masses, musculoskeletal diseases and renal disorders were target conditions. The data extracted by the two reviewers concerning selected study characteristics and results were presented in tables and figures. In total, 46 studies were found for breast masses, lymph nodes, prostate carcinoma, liver diseases, salivary and parotid gland diseases, pancreatic masses, musculoskeletal diseases and renal diseases, and the overall sensitivity of sonoelastography in diagnosing all these diseases was 83.14% while specificity was 81.41%. This literature review demonstrates that sonoelastography is characterized by high sensitivity and specificity in diagnosing different disorders of the body.

Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography

Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen’s duct stenosis. Sialendoscopy directly confirmed Stensen’s duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen’s duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjögren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen’s duct stenosis and may similarly have limitation in the treatment of Sjögren’s syndrome and recurrent parotitis.

Fine-needle aspiration cytology (FNAC): is it useful in preoperative diagnosis of parotid gland lesions?

Background: Salivary gland tumors are an uncommon entity and its histopathology is highly varied due to heterogeneous cellular composition. The role of the preoperative fine-needle aspiration cytology (FNAC) remains controversial. The purpose of this study is to compare the cytologic findings of salivary gland lesions with the histologic diagnoses, in order to assess the usefulness and accuracy of fine-needle aspiration cytology in the diagnosis of parotid gland tumors.Methods: A retrospective study was performed, regarding patients (n = 65) submitted to surgery for the treatment of parotid gland disease, who had performed preoperative FNAC, in our department between 2002 and 2012.A histologic diagnosis was considered as the gold standard for the assessment of sensitivity and specificity of FNAC. A cytohistologic correlation was done and appropriate statistical tests were applied.Results: Concordance between FNAC and histological specimen analysis was 78%. FNAC specificity was 82% and sensitivity was 71%. Positive and negative predictive values were 65% and 86% and positive likelihood ratio and negative likelihood ratio were 3.92 and 0.35, respectively. The diagnostic accuracy for this test was 78%.Conclusion: Preoperative FNAC of parotid lesions is reasonably accurate and useful in diagnosing benign from malignant lesions and in planning appropriate approach for treatment.