Background: Differentiation of parotid neoplasms from extraparotid upper ce
rvical lesions is difficult by physical examination. The purpose of this re
port is to identify the role of office-based parotid ultrasound (US) in the
evaluation of periauricular masses.
Methods: A prospective database including the results of physical examinati
on, office-based US, and the corresponding pathology was reviewed. Soft-tis
sue US was performed with a 7.5-mHz parallel probe with biplanar imaging.
Results: Thirty-eight patients were evaluated over a 28-month period (mean
age, 45 years; range, 23-78 years). US demonstrated a mass within the subst
ance of the parotid (n = 23, 61%), outside the parotid (n = 11, 29%), or di
ffuse parotitis (n = 4, 10%). Intraparotid masses were preauricular (n = 14
), postauricular (n = 5), or upper cervical (n = 4) and were solid (n = 22)
or cystic (n = 1). Patients with solid intraparotid masses underwent super
ficial (n = 20) or total parotidectomy (n 2). Benign (n = 19) and malignant
(n = 3) solid parotid nodules had similar US features of hypoechogenicity
with posterior enhancement. Indistinct margins were noted in 3 of 3 maligna
nt lesions as well as 15 of 19 benign nodules (P = .9). Extraparotid masses
were confirmed to be nodal disease on the basis of observation with resolu
tion (n = 3), fine-needle aspiration (n = 6), or surgical removal (n = 2) (
mean follow-up, 6 months).
Conclusions: Surgical office-based parotid US can delineate the location of
periauricular mass lesions relative to the parotid gland. Benign and malig
nant lesions have a similar sonographic appearance.