The role of pre-operative CT-guided FNAB for parapharyngeal space tumors

OBJECTIVE: To determine the role of computed tomography (CT)-guided fine needle aspiration biopsy (FNAB) in surgical planning for parapharyngeal space (PPS) tumors. DESIGN AND SETTING: Chart review of 49 consecutive patients with surgically treated PPS tumors from 1995 to 2005. RESULTS: Twenty-nine patients had CT-guided FNAB. A cytopathologic diagnosis that was the same as final pathology was rendered in 14 (48%) patients; suggestive but not conclusive in 6 (21%) patients; discordant in 3 (10%) patients; and 6 (21%) patients had a nondiagnostic result. Fourteen of 15 patients who had a final histopathologic finding of pleomorphic adenoma had a correct or highly suggestive preoperative FNAB diagnosis. The positive predictive value for CT-guided FNAB to identify benign tumors is 90%, (18 of 20) but to identify malignant PPS tumors is 75% (3 of 4). CONCLUSION: CT-guided FNAB of PPS tumors is helpful to predict the nature of the PPS tumors (especially benign), which allows the surgeon and patient to plan for treatment, accordingly. (c) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.