Ultrasound can help to indirectly predict contact of parotid tumors to the facial nerve, correct intraglandular localization, and appropriate surgical technique

Background The purpose of this prospective study is to evaluate the role of ultrasound in benign parotid tumor surgery, particularly by helping to identify the tumor location and its relationship to the facial nerve (FN) and by predicting the appropriate surgical approach. Methods Fifty patients underwent preoperative ultrasound. The course of the FN was indirectly defined, and the following predictions were made: contact of the tumor with the FN, the necessity for intraoperative nerve exposure, localization in the correct parotid lobe, and choice of the appropriate surgical technique. Results Contact of parotid tumors with the FN was determined with an accuracy of 96%. The need for intraoperative nerve exposure was incorrectly determined only once. The appropriate surgical technique was correctly predicted in 98% of the patients. Conclusions Ultrasound is helpful for indirectly predicting the relationship between parotid tumors and the FN. The retromandibular vein is the most important landmark.