The utility of fine needle aspiration in parotid malignancy.

OBJECTIVE: To determine clinical utility of fine needle aspiration (FNA) in parotid neoplasia. STUDY DESIGN AND SETTING: Retrospective cohort study. METHODS: FNA and final pathology data were reviewed for patients who underwent parotidectomy for malignancy. Surgical outcomes were compared between patients with malignant cytology versus nonmalignant/nondiagnostic cytology. RESULTS: Twenty-seven of 33 primary malignant parotid lesions underwent FNA. Seventeen (63.0%) patients were diagnosed with cancer on FNA. The remaining 16 patients did not undergo FNA (n = 6), had a nondiagnostic FNA specimen (n = 5), or were incorrectly diagnosed with a benign lesion (n = 5). Patients who went on to parotidectomy with intent to treat malignancy based on FNA had significantly higher rates of upfront neck dissections (47.1% vs 12.5%, P = 0.036) as well as clear pathological margins (70.6% vs 31.3%, P = 0.027) vs those with nonmalignant FNA diagnoses. CONCLUSIONS: Preoperative FNA diagnosis of malignancy improves surgical treatment of parotid cancer. SIGNIFICANCE: FNA in the evaluation of parotid masses should strongly be considered.