title: Frozen section pathology for decision making in parotid surgery.
abstract: OBJECTIVE
  For parotid lesions, the high accuracy and utility of intraoperative frozen section (FS) pathology, compared with permanent section pathology, facilitates intraoperative decision making about the extent of surgery required.
  
  
  OBJECTIVE
  To demonstrate the accuracy and utility of FS pathology of parotid lesions as one factor in intraoperative decision making.
  
  
  METHODS
  Retrospective review of patients undergoing parotidectomy at a tertiary care center.
  
  
  METHODS
  Evaluation of the accuracy of FS pathology for parotid surgery by comparing FS pathology results with those of permanent section.
  
  
  METHODS
  Documented changes from FS to permanent section in 1339 parotidectomy pathology reports conducted from January 1, 2000, through December 31, 2009, included 693 benign and 268 primary and metastatic malignant tumors.
  
  
  RESULTS
  Changes in diagnosis were found from benign to malignant (n = 11) and malignant to benign (n = 2). Sensitivity and specificity of a malignant diagnosis were 98.5% and 99.0%, respectively. Other changes were for lymphoma vs inflammation or lymphoma typing (n = 89) and for confirmation of or change in tumor type for benign (n = 36) or malignant (n = 69) tumors. No case changed from low- to high-grade malignant tumor. Only 4 cases that changed from FS to permanent section would have affected intraoperative decision making. Three patients underwent additional surgery 2 to 3 weeks later. Overall, only 1 patient was overtreated (lymphoma initially deemed carcinoma).
  
  
  CONCLUSIONS
  Frozen section pathology for parotid lesions has high accuracy and utility in intraoperative decision making, facilitating timely complete procedures.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Olsen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.affiliation: Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jean E
authors.initials: JE
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003657:Decision Making; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000473:pathology / Q000601:surgery; D010306:Parotid Gland / Q000473:pathology* / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity