This series demonstrates histological outcomes in patients specific to the submandibular salivary gland. The malignancy rate was low compared to current published literature. The transcervical surgical approach to submandibular gland pathology is a safe and effective method with minimal morbidity when performed by experienced surgeons. No single investigative modality can be solely aligned with diagnosing a specific lesion of the submandibular gland.
With the ready availability of good quality portable units, office-based ultrasound (US) is increasingly being utilized by endocrine surgeons in their daily practices, particularly in the management of thyroid patients. Ultrasound-guided fine needle aspiration biopsy (US-FNAB) of thyroid lesions is a useful interventional diagnostic technique which can be readily performed by endocrine surgeons as an office-based procedure offering significant convenience for the patient. A retrospective review of US-FNAB's performed in a single surgeon practice between 2006 and 2008 was undertaken particularly assessing the diagnostic outcomes and complication rates. Factors affecting FNAB outcome were tested using Chi-square test and significance defined as p < 0.05. A total of 128 FNABs were performed on 100 patients in the time period under review. Mean lesion size was 22 mm, and the majority were solid on US. US-FNAB had sensitivity of 85%, accuracy 75%. No complications were reported. A total of 14.8% of samples were reported as either malignant, atypical or with Hurthle cell findings. In this series of patients, 22% of cases proceeded to thyroidectomy, 46% of which yielded malignancy. The nondiagnostic rate was only 5.5%. Solid lesions < 2 cm were associated with higher nondiagnostic rate (p = 0.04). Surgeon-performed thyroid US-FNAB is a safe and effective procedure which compares favorably to radiologist-performed series and offers a convenient 'one-stop' process for patients. In this series, it was associated with a low nondiagnostic rate and a low complication rate. Surgeon-performed US-FNAB techniques can be easily acquired; however, structured training and appropriate credentialing are important for the maintenance of quality assurance standards.
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