title: Rapid mandible margins for intraoperative assessment.
abstract: OBJECTIVE
  To determine the feasibility of a rapid method of processing mandible bone margins for intraoperative histopathologic examination and to assess the relative value of fine, coarse, and core specimens in assessing bone margins.
  
  
  METHODS
  Prospective histologic controlled study.
  
  
  METHODS
  A tertiary level academic medical center histopathology laboratory.
  
  
  METHODS
  Multiple bone samples were collected from fresh (<12 hours post-mortem) human cadaveric mandible using a 1) standard 4mm otolaryngologic cutting drill bit 2) diamond drill bit and 3) cutting core biopsy trocar. The specimens were placed in one of three decalcifying solutions (Decal A, Calex, EDTA Decal) from 15 to 75 minutes or control (fixation in 10% formalin). After each designated decalcification time period, specimens were cryosectioned or paraffin embedded and subsequently reviewed by a head and neck surgical pathologist. The specimens were assessed for overall quality, adequacy of decalcification, soft tissue quality, marrow quality, and presence of artifact.
  
  
  RESULTS
  Bone margin specimens collected with a 4mm burr and processed with EDTA Decal for 30 minutes yielded the highest quality histopathologic slides compared to the other methods in a similar time frame. The adequacy of decalcification directly impacted the quality of histopathologic assessment.
  
  
  CONCLUSIONS
  Mandible bone margins can be rapidly and safely prepared and adequately evaluated with only 30 minutes of decalcification. This method may provide acceptable intraoperative assessment of bone margins in patients with tumors which involve or approximate bone. We plan to examine this model in a prospective clinical study of patients with cancer invading mandibular bone.
authors: Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN. Electronic address: almayer@iupui.edu.
authors: Allison
authors: A
authors: Mayer
authors: Department of Otolaryngology-Head and Neck Surgery, Witham Memorial Hospital, Lebanon, IN.
authors: Mark C
authors: MC
authors: Royer
authors: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors: Don-Jon
authors: DJ
authors: Summerlin
authors: Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN.
authors: Michael
authors: M
authors: Moore
authors: Richard L. Roudebush V.A. Medical Center, Indianapolis, IN.
authors: Chad
authors: C
authors: Galer
authors: Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN.
authors: Taha Z
authors: TZ
authors: Shipchandler
authors: Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indiana University Health Physicians, Indianapolis, IN.
authors: Mimi S
authors: MS
authors: Kokoska
mesh_terms: D002102:Cadaver; D065096:Calcium Chelating Agents; D003648:Decalcification Technique / Q000379:methods*; D004492:Edetic Acid; D005240:Feasibility Studies; D016591:Histocytological Preparation Techniques / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D008334:Mandible / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors
chemical_list: D065096:Calcium Chelating Agents; D004492:Edetic Acid