The sensitivity and specificity of frozen-section histopathology in the management of benign oral and maxillofacial lesions.
OBJECTIVE
The management of odontogenic cysts and tumors typically requires a biopsy, which may present significant challenges and prompt an additional visit to the operating room before definitive treatment. The aim of this study was to determine the validity of frozen-section diagnosis in the management of benign oral and maxillofacial lesions, allowing intraoperative diagnosis followed by definitive treatment under the same general anesthetic.


METHODS
A retrospective chart review of patients treated at the University of Michigan Health System was performed. Patients of all ages who had a diagnosis of a benign maxillofacial lesion by frozen-section and permanent histopathology reports were included for analysis. Patients were identified using the Current Procedural Terminology code for enucleation and curettage and International Classification of Diseases, Ninth Revision codes for benign cysts or tumors of skull, face, or lower jaw.


RESULTS
Of 450 patients reviewed, 214 had intraoperative frozen-section examination available for comparison with permanent histopathology. There were 121 men (56.5%) and 93 women (43.5%), with a mean age of 41 years. Compared with final permanent histopathology, the overall sensitivity of frozen sections was 92.1%. Frozen-section histopathology had a sensitivity greater than 90% and a specificity greater than 95% for the diagnosis of dentigerous cyst and keratocyst odontogenic tumor.


CONCLUSIONS
In this study of 214 patients with benign maxillofacial lesions, frozen-section histopathology was found to be a valid diagnostic modality with high sensitivity, specificity, and positive and negative predictive values. These results and analysis support the use of frozen-section histopathology for the treatment of benign maxillofacial lesions and underscore its value in the management of these lesions.
Clinical Assistant Professor and Assistant Program Director, Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Michigan and University of Michigan School of Dentistry, Ann Arbor, MI. Electronic address: saronovi@med.umich.edu.
Sharon
S
Aronovich
Resident; MD/OMFS Candidate University of Michigan Medical School, Ann Arbor, MI.
Roderick Y
RY
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000564:Ameloblastoma / Q000473:pathology; D002648:Child; D003803:Dentigerous Cyst / Q000473:pathology; D005153:Facial Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections / Q000706:statistics & numerical data*; D006101:Granuloma, Giant Cell / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007430:Intraoperative Care; D007570:Jaw Cysts / Q000473:pathology; D007571:Jaw Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009807:Odontogenic Cysts / Q000473:pathology; D009808:Odontogenic Tumors / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult