title: Perioperative frozen section examination in parotid gland tumors.
abstract: BACKGROUND
  The minimal recommended surgical approach to parotid tumors is partial parotidectomy with resection of the superficial lobe of the gland. Histologic diagnosis prior to surgery is not possible, as incisional biopsies are contraindicated due to the possibility of facial nerve injury or incomplete tumor resection. Thus, the biopsies tend to be perioperative.
  
  
  OBJECTIVE
  To compare the results of frozen section examination with the definitive pathological diagnosis.
  
  
  METHODS
  Accuracy study by retrospective analysis.
  
  
  METHODS
  Head and Neck Surgery Service of Heliópolis Hospital, São Paulo, Brazil.
  
  
  METHODS
  153 cases of parotid gland tumors treated between 1977 and 1994.
  
  
  METHODS
  Frozen section and pathological diagnosis.
  
  
  METHODS
  Sensibility and specificity of the frozen section examination.
  
  
  RESULTS
  Frozen section study diagnosed 19 (12.4%) malignant and 127 (83.7%) benign tumors. Sensitivity of the frozen sections for malignancy was 61.5% (95% CI 54 to 69%) and specificity was 98% (95% CI 94 to 100%), and this result is comparable to the literature.
  
  
  CONCLUSIONS
  We consider that frozen section examination for salivary gland tumors is not sufficient on its own for deciding on the best management. Their interpretation must be correlated with clinical and intraoperative findings, in association with the surgeon's experience.
authors.affiliation: Head and Neck Surgery Service, Heliópolis Hospital, São Paulo, Brazil. sccphh@uol.com.br
authors.forename: M B
authors.initials: MB
authors.lastname: Carvalho
authors.forename: J M
authors.initials: JM
authors.lastname: Soares
authors.forename: A
authors.initials: A
authors.lastname: Rapoport
authors.forename: J
authors.initials: J
authors.lastname: Andrade Sobrinho
authors.forename: A S
authors.initials: AS
authors.lastname: Fava
authors.forename: J L
authors.initials: JL
authors.lastname: Kanda
authors.forename: C N
authors.initials: CN
authors.lastname: Lehn
authors.forename: F
authors.initials: F
authors.lastname: Walder
authors.forename: M B
authors.initials: MB
authors.lastname: Menezes
authors.forename: S L
authors.initials: SL
authors.lastname: Negri
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005188:False Negative Reactions; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies