Contribution to the Preoperative Diagnosis of Tumours of theSalivary Glands

Overview

The authors compare the contribution of examination methods - sonography, cytologyfrom fine needle biopsy, sialography, computer tomography and magnetic resonance in the preope-rative diagnosis of salivary gland tumours. On a group of their patients they compare agreementbetween the preoperative diagnosis with the final histological finding. They recommend a dia-gnostic procedure consistent with findings of the implemented study and compare this procedurewith the results of other authors. FNAB with cytological examination was implemented in 44patients in 1995-1998 where the sensitivity for a malignant tumour of the salivary glands was 87%and the specificity 94%. The results of sialography which was evaluated in 167 patients in 1980-98revealed a sensitivity for malignant salivary gland tumours in 65% and specificity in 92%. Theauthors evaluated also sonography in 46 patients with salivary gland tumours, computer bytomography in 21 patients and magnetic resonance in two patients. Based on their findings theyrecommend in the preoperative diagnosis of salivary gland disease the following procedure: as theexamination method of first choice they recommend sonography which visualizes in a simple way,not burdening the patient, the salivary gland, differentiates hypertrophy, inflammatory swellingfrom a tumourous process where it can detect whether a single or multiple affection is involved andit visualizes possible affection of the cervical nodes. If the authors suspected from the case-history,physical examination and sonography the presence of a tumour, FNAB is made under ultrasoniccontrol. If these examinations lead to the preoperative diagnosis of a benign tumour of the subman-dibular gland or surface layer of the parotid gland, they do not use any further examination methods.If they reveal affection of the deep layer of the parotid gland, a more extensive tumour withextraglandular propagation, or if a relapse of a malignant tumour is involved, they indicate CT orpossibly MR.

Key words:
tumours of the salivary glands, sonography, FNAB, sialography.