Parotid FNAC Diagnostic Utility and Its Role in Surgical Residency Training

Document Type : Original

Authors

1 Otolaryngology Department, School of Medicine, National & Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece.

2 Department of Surgery, School of Medicine, National & Kapodistrian University of Athens, Attikon” University Hospital, Athens, Greece.

Abstract

Introduction:
This study aimed to investigate the relationship between preoperative fine needle aspiration cytology (FNAC) for parotid tumors and the level of surgical training among residents, as well as  to further elucidate its effectiveness  as a diagnostic tool in the hands of the treating physician.
 
Materials and Methods:
Surgical records from patients who underwent parotid surgery between 2014 and 2022 were retrieved. Residents reported their perceived level of training duringthese procedures. Contingency tables were used to correlate the cytological with final histopathological results.
 
Results:
A total of 286 patients who had undergone preoperative FNAC were included in the study. A preoperative diagnosis of pleomorphic adenoma or Wharthin’s tumor was significantly associated with higher training scores among surgical residents. In contrast, a   diagnosis of malignancy, other benign tumors, or indeterminate cytology was correlated with poor training scores (χ2 = 176.35; df = 2; p-value <0.001, Cramer’s V 0.79).   FNAC demonstrated a sensitivity of 88% and a specificity of 99.2% for detecting malignancy, with a positive likelihood ratio of 103.8 (95% CI: 26.02–414.34) and a negative likelihood ratio of 0.12 (95% CI: 0.06–0.26).
 
Conclusions:
Our findingssuggest that preoperative cytological diagnoses of parotid tumors with a favorable prognosis, such as Wharthin’s tumors, can enhance training and mentorship opportunities provided by senior surgeons. This is  particularly significant for academic institutions with residency programs.

Keywords

Main Subjects

References

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Iranian Journal of Otorhinolaryngology
Volume 36, Issue 6
November and December 2024
Pages 675-680

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