Parotid Gland Tumors: An Institutional 8-Year Retrospective Study Spanning the COVID-19 Pandemic and Global Diagnostic Trends

<b>Background/Objectives</b>: Despite the relative rarity of salivary gland tumours (SGT), they are a complex and challenging pathology. This is primarily due to the complexity of surgical treatment, the difficulty of diagnosis, and the sometimes ambiguous prognosis. <b>Methods:</b> This retrospective study examined parotid gland tumors in patients admitted for diagnosis and treatment at the Municipal Hospital of Timisoara-Oral and Maxillofacial Surgery Clinic, Romania, from 2016 to 2023, with the objective of verifying the hypothesis regarding the increasing incidence of benign tumors in the major salivary glands, particularly the parotid gland. <b>Results</b>: A total of 207 consecutive parotid nodular lesion cases were analysed, with 186 having a histopathological analysis. The findings encompass demographic patterns, temporal dynamics, histopathological profiles, malignancy characteristics, and statistical associations. The cohort was evenly distributed by sex (102 females, 105 males) with a median age of 58 years (IQR: 46-69). The largest age group was ≥60 years (n = 99; 47.8%), followed by 40-59 years (n = 76; 36.7%) and <40 years (n = 32; 15.5%). No significant sex difference in age distribution was observed. Annual case volumes showed a high plateau between 2017-2019 (40-41 cases/year), then fell sharply during the pandemic (2020-2022), reaching a nadir in 2021 (11 cases). A partial rebound occurred in 2023 (21 cases). The relative proportion of malignant diagnoses remained stable between pre-pandemic (20.0%) and pandemic/post-pandemic (8.9%) intervals, consistent with prioritization of oncologic surgeries during service restrictions. Benign tumors predominated (n = 126; 60.9%), led by pleomorphic adenoma (n = 64; 50.8% of benign) and Warthin tumor (n = 59; 46.8% of benign). Malignant tumors accounted for 31 cases (15.0%), most commonly squamous cell carcinoma (n = 6), mucoepidermoid carcinoma (n = 6), and adenocarcinoma of salivary origin (n = 5). Mann-Whitney U tests confirmed no significant differences in median age between malignant and benign cases, or between pre-pandemic and pandemic/post-pandemic intervals. Odds ratios suggested clinically relevant but non-significant increases in malignancy risk for males (OR ≈ 2.1) and for patients ≥60 years (OR ≈ 1.2). Linear regression of annual case counts revealed a downward slope of -3.5 cases/year (<i>p</i> ≈ 0.074), driven by the sharp pandemic-era decline. <b>Conclusions</b>: This study illustrates that, despite a significant decrease in surgical case volume during the COVID-19 pandemic, the relative distribution of parotid tumor pathology remained stable. Malignant lesions mostly occurred in older patients and males, with no statistically significant differences seen among demographic or clinical subgroups. The preservation of consistent malignancy detection rates, despite limited surgical capacity, underscores the efficacy of oncologic prioritization under healthcare disruptions.