Skip to main content
Log in

Preoperative Prediction of the Location of Parotid Gland Tumors using Anatomical Landmarks

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



The location of the parotid gland tumor can affect the duration and difficulty of operation. Therefore, accurate preoperative evaluation of tumor location can affect surgical outcomes.


Results in 100 patients with parotid gland tumors who underwent parotidectomy between January 2000 and October 2005 were retrospectively reviewed. Tumor location was determined relative to four landmarks—facial nerve (FN) line, Utrecht (U) line, Conn’s arc (CA), and retromandibular vein (RV)—on computerized tomography (CT) scans, and confirmed by intraoperative findings. The accuracy of each landmark was evaluated. Correlations between accuracy and tumor size were determined for tumors ≤2 cm and >2 cm in diameter.


Of the four landmarks, the U line was the most accurate (94%), sensitive (89.3%), and specific (97.7%) in predicting tumor location. However, for tumors ≤2 cm in diameter, FN line (p = 0.022) and RV (p = 0.028) were significantly more accurate than U line and CA.


Although the U line was the most accurate in predicting the location of parotid gland tumors, landmarks predicting accurate tumor location should be selected according to tumor size.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others


  1. DelBalso AM, Ellis GE, Hartman KS et al (1990) Diagnostic imaging of the salivary glands and periglandular regions. WB Saunders, Philadelphia

    Google Scholar 

  2. Smith JRG, King WWK, Tang WYM et al (1987) Differentiating tumours of the deep and superficial lobes of the parotid gland by computed tomographic sialography. Clin Radiol 38:345–349

    Article  PubMed  CAS  Google Scholar 

  3. Stone DN, Mancuso AA, Rice D et al (1981) Parotid CT sialography. Radiology 138:393–397

    PubMed  CAS  Google Scholar 

  4. Rice DH, Mancuso AA, Hanafee WN (1980) Computerized tomography with simultaneous sialography in evaluating parotid tumors. Arch Otolaryngol 106:472–473

    PubMed  CAS  Google Scholar 

  5. Sone S, Higashihara T, Morimoto S et al (1982) CT of parotid tumors. Am J Neuroradiol 3:143–147

    PubMed  CAS  Google Scholar 

  6. Bryan RN, Miller RH, Ferreyro RI et al (1982) Computed tomography of the major salivary glands. Am J Roentgenol 139:547–554

    CAS  Google Scholar 

  7. Eracleous E, Kallis S, Tziakouri C et al (1997) Sonography, CT, CT sialography, MRI and MRI sialography in investigation of the facial nerve and the differentiation between deep and superficial parotid lesions. Neuroradiology 39:506–511

    Article  PubMed  CAS  Google Scholar 

  8. Conn IG, Wiesenfeld D, Ferguson MM (1983) The anatomy of the facial nerve in relation to CT/sialography of the parotid gland. Br J Radiol 56:901–905

    Article  PubMed  CAS  Google Scholar 

  9. Ariyoshi Y, Shimahara M (1998) Determining whether a parotid tumor is in the superficial or deep lobe using magnetic resonance imaging. J Oral Maxillofac Surg 56:23–27

    Article  PubMed  CAS  Google Scholar 

  10. de Ru JA, van Benthem PP, Hordijk GJ (2002) The location of parotid gland tumors in relation to the facial nerve on magnetic resonance images and computed tomography scans. J Oral Maxillofac Surg 60:992–995

    Article  PubMed  Google Scholar 

  11. de Ru JA, Bleys RL, van Benthem PP et al (2001) Preoperative determination of the location of parotid gland tumors by analysis of the position of the facial nerve. J Oral Maxillofac Surg 59:525–530

    Article  PubMed  Google Scholar 

  12. Ragbir M, Dunaway DJ, Chippindale AJ et al (2002) Prediction of the position of the intraparotid portion of the facial nerve on MRI and CT. Br J Plast Surg 55:376–379

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Chi Young Lim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lim, C.Y., Chang, HS., Nam, KH. et al. Preoperative Prediction of the Location of Parotid Gland Tumors using Anatomical Landmarks. World J Surg 32, 2200–2203 (2008).

Download citation

  • Published:

  • Issue Date:

  • DOI: