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


CONCLUSIONS
This technique promises to be suitable for intraoperative detection of malignant bone infiltration.
Wysluch
Andreas
A
Department of Oral and Plastic Maxillofacial Surgery, Central German Armed Forces Hospital, Rübenacher Str. 170, D-56072 Koblenz. andreas.wysluch@gmx.de
Stricker
Ingo
I
Hölzle
Frank
F
Wolff
Klaus-Dietrich
KD
Maurer
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008339:Mandibular Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D012680:Sensitivity and Specificity