Frozen section during parotid surgery revisited: efficacy of its applications and changing trend of indications.
BACKGROUND
Efficacy of frozen sections was assessed in terms of its various applications. The changing role of frozen sections in parotid surgery was examined.


METHODS
Records of parotid operations over a 15-year period in a University Department of Head & Neck Surgery were reviewed.


RESULTS
Of 241 operations, frozen sections were performed on 32. Applications of frozen sections included diagnosis, margin clearance, and checking suspicious lymph nodes and nerve invasion. The false-positive rate for malignancy was 12.5%. Margins may still be involved despite correct tissue diagnosis from sampling error. No inappropriate surgery resulted from the information obtained. With the advent of fine-needle aspiration, frozen sections were less often called for and a shift from a diagnostic role to margin checking was seen. Frozen sections picked up all unsuspected malignant tumors.


CONCLUSIONS
Frozen sections are helpful when interpreted cautiously, but clinical assessment and fine-needle aspiration are also important components in the workup.
Wong
David Sau Yan
DS
Division of Head & Neck/Plastic & Reconstructive Surgery, Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Center, Pokfulam, Hong Kong, China. sywong@ha.org.hk
D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D005629:Frozen Sections / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity