title: The Utility of In-Office Ultrasound in the Diagnosis of Parotid Lesions.
abstract: Objective To determine whether the use of in-office ultrasound (US) by a head and neck surgeon is a useful adjunct to clinical assessment of parotid lesions and decrease the need of additional imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT). Study Design Case series with chart review. Setting Tertiary care academic center. Subjects Seventy patients presenting with a parotid lesion who obtained an in-office US and ultrasound-guided fine-needle aspiration (USGFNA) from a head and neck surgeon from 2006 to 2015. Methods US images were retrospectively reviewed for 70 patients and characterized by a radiologist and a head and neck surgeon. Results Of the 70 patients, 6 had US characteristics that demonstrated a statistically significant association with a benign/malignant diagnosis: depth from surface; irregular borders; presence of calcifications, which included either micro- or macro-calcifications; posterior echogenicity enhancement; irregular shape; and homogeneous/heterogeneous echotexture. Imaging was performed prior to referral in 25 cases (35.7%); of those, 17 (68%) were for superficial, small (<2 cm) tumors where prereferral imaging studies did not provide additional information to that obtained with US. Of the 55 patients without MRI or CT performed prior to referral, MRI or positron emission tomography-CT scan was obtained in only 4 patients (7.3%) in cases involving recurrent parotid lesions, large tumors, or workup of a malignant neoplasm. Conclusions Several US characteristics individually assist in lesion characterization. In-office US and USGFNA are an appropriate first-line modality in the assessment of parotid lesions, can allow for immediate parotid lesion assessment, and can decrease the need for additional imaging.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA.
authors.forename: Yarah M
authors.initials: YM
authors.lastname: Haidar
authors.forename: Omid
authors.initials: O
authors.lastname: Moshtaghi
authors.affiliation: 2 Department of Biomedical Engineering, University of California, Irvine, California, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Mahmoodi
authors.affiliation: 3 Department of Radiology, University of California, Irvine Medical Center, Irvine, California, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Helmy
authors.affiliation: 4 Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Goddard
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Irvine, California, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Armstrong
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010305:Parotid Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: in-office ultrasound; otolaryngology; parotid; ultrasound