Intraoperative evaluation of bony margins with frozen-section analysis and trephine drill extraction technique: A preliminary study

Head Neck. 2010 Nov;32(11):1473-8. doi: 10.1002/hed.21350.

Abstract

Background: The aim of this study was to examine the use of trephine drill specimens from mandible bony margins subjected to standard histologic fresh-frozen processing for intraoperative documentation of malignant bony infiltration in oral cancer.

Methods: Eighty-four drill specimens were extracted from bony mandibular resection margins of 20 patients with oral cancer. Histologic results of decalcification and of intraoperative frozen-section analysis were compared.

Results: Sixty-eight (81%) of 84 specimens showed no tumor infiltration, whereas 16 (19%) were positive in frozen section analysis. Four specimens (4.8%) were evaluated as free of tumor invasion, but showed erosion of the bone by the tumor after decalcification. One specimen (2.4%) was positive, but no invasion could be found with standard decalcification. Overall, there was 94% (79) consistency between the 2 techniques, with a sensitivity of 79% and specificity of 98%.

Conclusion: This technique promises to be suitable for intraoperative detection of malignant bone infiltration.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy / instrumentation*
  • Carcinoma, Squamous Cell / pathology*
  • Female
  • Frozen Sections*
  • Humans
  • Intraoperative Period
  • Male
  • Mandibular Neoplasms / diagnosis*
  • Mandibular Neoplasms / secondary
  • Middle Aged
  • Mouth Neoplasms / pathology*
  • Neoplasm Invasiveness
  • Sensitivity and Specificity