title: Histopathological assessment in glossectomy: harmonic shears versus monopolar electrosurgery pilot study.
abstract: OBJECTIVE
  The aim of the study was to gather information on outcomes and effect sizes of 2 surgical methods of glossectomy by using a grade system and an objective measure of artifacts in micrometers (µm). The collected data would be used to plan a definitive study.
  
  
  METHODS
  Pilot study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Nineteen patients affected with tongue cancer were consecutively enrolled in a pilot study and treated by partial glossectomy. Eleven patients (57.89%) of group A were treated with monopolar electrocautery, while 8 patients (42.10%) of group B were treated with Harmonic Focus Curved Shears. Specimens were examined by a pathologist blinded to the surgical procedure, using a 4-grade system for margin artifact assessment (margin fragmentation, cautery/crush artifact, extravascular blood clot, capillary congestion) and for measuring artifact depth.
  
  
  RESULTS
  Artifact depth was more relevant in group A (765,633 µm) than in group B (473,939 µm). The difference between groups was significant at the 95% confidence interval (P < .0001). Margin fragmentation and capillary congestion compared between the 2 groups were of no significance. There were less cautery/crush artifacts and extravascular blood clots observed in the harmonic shears group.
  
  
  CONCLUSIONS
  When used to perform a partial glossectomy, Harmonic Focus Curved Shears produce less cautery/crush artifact and a smaller artifact depth compared with monopolar cautery.
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Italian National Cancer Institute Regina Elena, Rome, Italy. cristalli@ifo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cristalli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mercante
authors.forename: Renato
authors.initials: R
authors.lastname: Covello
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Cristalli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spriano
mesh_terms: D016477:Artifacts; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D004598:Electrosurgery / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005927:Glossectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome