(A236) Prevalence and Surgical Management of Benign Parotid Neoplasms in a Veteran Population

Introduction: Parotid gland neoplasms account for approximately 70% of all salivary gland neoplasms. In the veteran population, the distribution of parotid neoplasms differs from the civilian population, likely due to their high incidence of heavy smoking. The purpose of the study was to understand the distribution of benign parotid gland neoplasms in the veteran population, as well as diagnostic concordance and treatment outcomes.

Methods: Through a retrospective cohort study, we identified veteran patients who underwent Fine Needle Aspirations (FNA) for parotid gland masses at the Michael E. DeBakey Veteran Affairs Medical Center (MEDVAMC) in Houston, Texas from January 2018 to June 2024. The exclusion criteria were patients whose FNA results indicated malignancy or normal tissue. Medical records were reviewed for both surgical and non-surgical patients and data aggregation was done by using Microsoft Excel 360. Descriptive statistics were used to summarize the data, with means calculated for continuous variables such as age and frequencies and percentages for categorical variables. Categorical variables were analyzed via chi-squared test with the p-value set at 0.05.

Results: We found that Warthin Tumors (WT) were the most common diagnosis in both groups, with 43% in FNA patients and 47.7% in surgical patients. In FNA patients, lymphocytic tissue and cysts were the second and third most common findings at 19% and 15.8%, respectively. In surgical patients, Pleomorphic Adenomas were the second most common at 27.3%, followed by cysts at 9.1%. In the surgical cohort, 87.5% of patients demonstrated concordance between FNA and final surgical pathology. Surgical patients experienced low complication rates, with sialoceles/salivary fistula being the most common at 8%. Notably, there was no recurrence in any of the surgical patients at the time of data collection.

Conclusions: We conclude that in this Veteran and majority male population, WT was the most prevalent parotid neoplasm, strongly associated with heavy tobacco use. The absence of recurrence and low complication rates in surgical patients suggests effective management.