Background: There are multiple studies outside the UK evaluating the utility of both fine needle aspiration cytology (FNAC) and frozen section histopathology (FS) in the management of parotid gland tumours. There is some contention regarding the use of FS to base treatment decisions. Objectives: We sought to clarify whether the findings from our UK study are in agreement with the world literature. Methods: A retrospective review of all patients undergoing parotid surgery by the same consultant ENT surgeon at our institution over a 5 year period from September 2012 to September 2017. We collected data on age, gender, initial radiological imaging, FNAC, FS if performed and final histological diagnosis. Results: 75 patients were identified. 55 had pre-operative FNAC and 17 had intra-operative FS. The accuracy of pre-operative FNAC was 81% and concordance with final histology was 82% for benign lesions and 71% for malignant lesions. The accuracy of intra-operative FS was 88% and concordance with final histology was 92% for benign lesions and 100% for malignant lesions. Conclusion: In our study, FS was more accurate than FNAC; particularly in detecting malignant lesions. Our findings tend to agree with UK National Multidisciplinary Guidelines which suggest ultrasound guided FNAC for all salivary tumours. However, in cases where pre-operative FNAC remains non-diagnostic, FS may help to detect the presence of malignancy and guide operative decision-making.
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